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Individual
JOHANNA CAROLINA PURDY
Active
Individual
JOHANNA CAROLINA PURDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12840412-1205
UT
208M00000X
Hospitalist Physician
Primary
12840412-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
PG205552
OR
Other
Enumeration date
03/20/2019
Last updated
08/28/2022
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