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General NPI Number Information
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NPI Number | 1649083619
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Entity Type | Individual
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Provider Name | KRISTINA PURDOM RN
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Gender | Female
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | PO BOX 8312
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City | ST JOHN
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State | VI
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Zip | 00831-8312
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Country | US
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Telephone | 340-776-8311
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Fax | 340-693-9506
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Provider Business Mailing Address
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Address Line | PO BOX 1112
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City | ST JOHN
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State | VI
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Zip | 00831-1112
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Country | US
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Telephone | 206-399-2971
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 13190
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License Number State | VI
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