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Individual

MICHELLE L PURCARO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN APRN

Contact information

Practice address
1075 CHASE PKWY, SUITE A, WATERBURY, CT 06708
(203) 591-3077
(203) 591-3074
Mailing address
1075 CHASE PKWY, SUITE A, WATERBURY, CT 06708
(203) 591-3077
(203) 591-3074

Taxonomy

Speciality
Code
Description
License number
State
163WX0200X
Oncology Registered Nurse
E57760
CT
363L00000X
Nurse Practitioner
Primary
002095
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002095
STATE ID
05
004228054
CT
01
00422805400
WORKERS COMP
01
264072
WELLCARE
01
2V3630
HEALTHNET
01
3521911693003
EMPLOYER ID
01
400002095CT01
ANTHEM BCBS
01
500028949
RAILROAD MEDICARE
Enumeration date
08/17/2006
Last updated
07/16/2014
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