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General NPI Number Information
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NPI Number | 1417509647
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Entity Type | Individual
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Provider Name | AMBER MARIE PURDY PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/09/2019
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Last Update Date | 11/17/2020
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Provider Practice Location Address
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Address Line | 7651 LAKE RAYSTOWN SHOPPING CTR
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City | HUNTINGDON
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State | PA
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Zip | 16652-8403
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Country | US
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Telephone | 814-643-8750
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Fax |
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Provider Business Mailing Address
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Address Line | 1225 WARM SPRINGS AVE
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City | HUNTINGDON
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State | PA
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Zip | 16652-2350
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Country | US
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Telephone | 814-643-8295
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA060828
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | OA004902
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License Number State | PA
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