Individual
ELLIE PURDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
130 RIVERSTONE TER STE 102, CANTON, GA 30114-1702
(706) 281-2313
Mailing address
130 RIVERSTONE TER STE 102, CANTON, GA 30114-1702
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN227523
GA
Other
Enumeration date
10/04/2017
Last updated
10/23/2018
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