Healthcare Provider Details

I. General information

NPI: 1063247286
Provider Name (Legal Business Name): KIMBERLY KATE PURCELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E ROOSEVELT AVE
NEW CASTLE DE
19720-3316
US

IV. Provider business mailing address

212 ERMINE DR
NEW CASTLE DE
19720-7692
US

V. Phone/Fax

Practice location:
  • Phone: 302-323-2901
  • Fax:
Mailing address:
  • Phone: 302-894-2489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberL1-0052479
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberL1-0052479
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberL1-0052479
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: