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General NPI Number Information
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NPI Number | 1538802962
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Entity Type | Individual
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Provider Name | STACI PURVIS MSW
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Gender | Female
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Dates
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Enumeration Date | 04/14/2022
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Last Update Date | 04/14/2022
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Provider Practice Location Address
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Address Line | 427 E DENNIS AVE
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City | NASHVILLE
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State | GA
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Zip | 31639-2504
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Country | US
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Telephone | 229-237-0655
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Fax |
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Provider Business Mailing Address
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Address Line | 532 HIGHWAY 37
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City | ADEL
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State | GA
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Zip | 31620-8508
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Country | US
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Telephone | 229-561-4222
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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