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General NPI Number Information
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NPI Number | 1679496459
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Entity Type | Organization
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Legal Business Name | PURE PEDIATRICS & WELLNESS LLC
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Dates
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Enumeration Date | 07/30/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 893B HARRISON ST SE
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City | LEESBURG
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State | VA
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Zip | 20175-4519
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Country | US
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Telephone | 571-308-2813
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Fax | 800-305-8056
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Provider Business Mailing Address
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Address Line | 893B HARRISON ST SE
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City | LEESBURG
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State | VA
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Zip | 20175-4519
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Country | US
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Telephone | 571-308-2813
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Fax | 800-305-8056
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Authorized Official
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Title or Position | DIRECTOR
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Name | KATIE ANNE MACDONALD
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Credential | CPNP-PC
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Telephone | 240-678-3397
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 202D00000X
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Taxonomy Name | Integrative Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number |
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License Number State |
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