Individual
MANDI REBECCA PURCELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
117 KITE RD, SWAINSBORO, GA 30401-3231
(478) 289-1100
Mailing address
114 HICKS AVE, SWAINSBORO, GA 30401-4923
(478) 494-1978
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN154114
GA
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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