Individual
STACIA R PURCELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, CDCES
Contact information
Practice address
5300 DON MANUEL RD, ELKTON, FL 32033-3222
(904) 662-2887
Mailing address
5300 DON MANUEL RD, ELKTON, FL 32033-3222
(904) 662-2887
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
ND2080
FL
Other
Enumeration date
02/01/2024
Last updated
02/15/2024
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