Individual
CHERRYL D PURVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
15444 DEDEAUX RD STE B, GULFPORT, MS 39503-2637
(228) 832-9038
(228) 832-9990
Mailing address
15444 DEDEAUX RD STE B, GULFPORT, MS 39503-2637
(228) 832-9038
(228) 832-9990
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
R655481
MS
363LF0000X
Family Nurse Practitioner
Primary
R655481
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00201815
—
MS
01
—
R655481
MS - STATE LICENSE
MS
Enumeration date
03/01/2007
Last updated
10/07/2019
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