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General NPI Number Information
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NPI Number | 1790784429
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Entity Type | Individual
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Provider Name | WYNDHAM PURSLEY CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/15/2005
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 401 YOUNG AVE STE 146D
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City | MOORESTOWN
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State | NJ
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Zip | 08057-3130
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Country | US
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Telephone | 888-982-3726
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Fax |
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone |
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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 | RN345567L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | LG0000208
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9297250
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | UP004711B
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 26NJ00318200
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License Number State | NJ
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Taxonomy #6
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | 26NJ00318200
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License Number State | NJ
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