Individual
WANDA PURNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7621 PITCHER PT APT 203, FOUNTAIN, CO 80817-4816
(719) 526-6009
Mailing address
7621 PITCHER PT APT 203, FOUNTAIN, CO 80817-4816
(719) 526-6009
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0002059367
VA
Other
Enumeration date
12/20/2013
Last updated
12/20/2013
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