Individual
MILDRED MAURILLO PURTELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
203 DARTMOUTH DR, MIDLAND, MI 48640-4513
(989) 839-2311
(800) 336-0596
Mailing address
312 GREEN AVE, BAY CITY, MI 48708-6887
(989) 600-7369
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703101031
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4703101031
—
MI
Enumeration date
12/09/2019
Last updated
11/27/2023
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