Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 622 | NC |
N | 213ES0103X | Foot & Ankle Surgery | 622 | NC |
NPI | 1568484749 |
---|---|
Provider Name | Dr. Jennifer H Purvis |
First Address | Rocky Mount, NC 27804-3521 |
Second Address | Rocky Mount, NC 27804-3521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 02/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NCJ639A | (02) | NC |