Purcell, Blake G

Purcell, Blake G is an individual health care provider with primary practice located at 1485 Parkway Dr , Blackfoot ID 83221-1667. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Purcell, Blake G can be contacted via phone (208) 785-5100.

Contact Information

Primary practice address
1485 Parkway Dr Blackfoot ID 83221-1667
Phone: (208) 785-5100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RNA52 Idaho

Profile Details

NPI number 1063590107
LBN Legal business name Purcell, Blake G
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2006
Last updated Sep 19th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063590107 NPPES
Idaho MEDICAID 1063590107

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