Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | PA16086 | CA |
N | 207N00000X | Dermatologist | PA2008-0007 | NM |
NPI | 1043336126 |
---|---|
Provider Name | Carol Purcell |
First Address | Albuquerque, NM 87111-3670 |
Second Address | Albuquerque, NM 87111-3670 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2007 |
Last Update Date | 07/07/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
17724261 | (05) | NM |
202027635 | PRESBYTERIAN HEALTH (01) | NM |