MEDICARE: ANGELA PURCER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WE0003X	Emergency Registered Nurse	76062	OK
2	363LF0000X	Family Nurse Practitioner	76062	OK

General Provider Information

NPI Number	:	1174099691
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA PURCER

Provider Business Mailing Address
First Line	:	1221 S SUNNYLANE RD
Second Line	:
City	:	DEL CITY
State	:	OK
Zip	:	73115-3011
Country	:	US
Telephone Number	:	405-677-2424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1221 S SUNNYLANE RD
Second Line	:
City	:	DEL CITY
State	:	OK
Zip	:	73115-3011
Country	:	US
Telephone Number	:	405-677-2424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2018
Last Update Date	:	03/07/2022

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Directions to “ ANGELA PURCER ” Practice Location

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