Healthcare Provider Details
I. General information
NPI: 1770066961
Provider Name (Legal Business Name): SANDRA PURCELL MSN, RN CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/13/2018
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US
IV. Provider business mailing address
30 SHATTUCK RD UNIT 4212
ANDOVER MA
01810-2481
US
V. Phone/Fax
- Phone: 352-273-8379
- Fax: 352-294-8098
- Phone: 413-265-5282
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 95032513 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | 7849 |
| License Number State | CT |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | APRN11043110 |
| License Number State | FL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | RN264027 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: