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Individual

MS. CARLA MARIE PURVIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6321 NEW UTRECHT AVE, BROOKLYN, NY 11219
(212) 687-7464
Mailing address
228 STUYVESANT AVE APT 2, BROOKLYN, NY 11221-1730
(917) 815-2326

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
752181
NY
164W00000X
Licensed Practical Nurse
Primary
320690
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1619361714
NY
Enumeration date
03/26/2015
Last updated
07/30/2018
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