Healthcare Provider Details

I. General information

NPI: 1821923665
Provider Name (Legal Business Name): PURCELL HOMETOWN CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 W MAIN ST
PURCELL OK
73080-4222
US

IV. Provider business mailing address

218 W MAIN ST
PURCELL OK
73080-4222
US

V. Phone/Fax

Practice location:
  • Phone: 405-890-1005
  • Fax: 405-890-1007
Mailing address:
  • Phone: 405-209-2502
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: WENDY WILBUR
Title or Position: OWNER
Credential: NP
Phone: 405-209-2502