Healthcare Provider Details

I. General information

NPI: 1962761759
Provider Name (Legal Business Name): DALE PURRINGTON MSN, RN, PNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2012
Last Update Date: 05/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E MARSHALL ST MAIN HOSPITAL, 7TH FLR, RM 7-067
RICHMOND VA
23298-5051
US

IV. Provider business mailing address

PO BOX 980530 MAIN HOSPITAL, 7TH FLR, RM 7-067
RICHMOND VA
23298-0530
US

V. Phone/Fax

Practice location:
  • Phone: 804-828-4987
  • Fax: 804-628-2138
Mailing address:
  • Phone: 804-828-4987
  • Fax: 804-628-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number20111212
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0024164306
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number0001142388
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: