Individual
KIAH PURCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1 GUSTAVE L LEVY PL, NEW YORK, NY 10029-6504
(310) 293-5429
Mailing address
1100 GRAND CONCOURSE APT 6J, BRONX, NY 10456-3938
(310) 293-5429
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309826
NY
Other
Enumeration date
08/07/2020
Last updated
12/21/2020
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