MEDICARE: AMBER DAWN PURVINE PA-C

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	363A00000X	Physician Assistant	1333	OK

General Provider Information

NPI Number	:	1881765808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER DAWN PURVINE PA-C

Provider Business Mailing Address
First Line	:	2556 COVELL VILLAGE DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-9731
Country	:	US
Telephone Number	:	405-938-0700
Fax Number	:

Provider Business Practice Location Address
First Line	:	2556 COVELL VILLAGE DR
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73003-9731
Country	:	US
Telephone Number	:	405-938-0700
Fax Number	:

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

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	12/10/2025

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Directions to “ AMBER DAWN PURVINE PA-C” Practice Location

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