Healthcare Provider Details

I. General information

NPI: 1023932373
Provider Name (Legal Business Name): PUREWELL MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3325 JOYNER BRIDGE RD
FOUR OAKS NC
27524-8896
US

IV. Provider business mailing address

3325 JOYNER BRIDGE RD
FOUR OAKS NC
27524-8896
US

V. Phone/Fax

Practice location:
  • Phone: 984-405-9592
  • Fax:
Mailing address:
  • Phone: 919-398-2074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CIERRA ALFORD PARKS
Title or Position: NURSE PRACTITIONER, OWNER
Credential: NP
Phone: 919-398-2074