Individual
JANNINE PURCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
910 E HOUSTON ST STE 550, TYLER, TX 75702-8366
(903) 510-8718
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6400
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
0327
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
359051501
—
TX
01
—
75-2616977--008
TRICARE
TX
01
—
8979NU
BCBS
TX
01
—
P01635758
RAIL ROAD MEDICARE
TX
Enumeration date
06/21/2006
Last updated
08/12/2016
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