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General NPI Number Information
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NPI Number | 1720618150
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Entity Type | Individual
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Provider Name | MICHELE LEE PURKEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/24/2020
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 64 BLUFFTON RD
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City | BLUFFTON
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State | SC
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Zip | 29910-7621
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Country | US
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Telephone | 843-757-0676
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Fax |
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Provider Business Mailing Address
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Address Line | 64 PINE RIDGE DR
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City | BLUFFTON
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State | SC
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Zip | 29910-7850
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Country | US
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Telephone | 850-570-8881
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9112932
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License Number State | FL
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