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General NPI Number Information
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NPI Number | 1942595970
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Entity Type | Individual
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Provider Name | KIMBERLY ALLYSON PURCELL RRT
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Gender | Female
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Dates
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Enumeration Date | 06/17/2011
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Last Update Date | 06/17/2011
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Provider Practice Location Address
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Address Line | 323 HWY 11 AND 42N
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City | LEWISTON WOODVILLE
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State | NC
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Zip | 27909-3473
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Country | US
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Telephone | 252-348-2763
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Fax |
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Provider Business Mailing Address
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Address Line | 323 HWY 11 NORTH PO BOX 597
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City | LEWISTON WOODVILLE
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State | NC
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Zip | 27909-3473
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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 | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | A-2503
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License Number State | NC
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