Purcell, Brian Blake

Purcell, Brian Blake is an sole proprietor health care provider with primary practice located at 1485 Parkway Dr , Blackfoot ID 83221-1667. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, Nursing Service Providers / Critical Care Medicine. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Purcell, Brian Blake 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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RNA-937A Idaho
Nursing Service Providers / Critical Care Medicine 163WC0200X N42090 Idaho

Profile Details

NPI number 1801273321
LBN Legal business name Purcell, Brian Blake
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 5th, 2015
Last updated Dec 9th, 2016 - about 8 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 1801273321 NPPES
Idaho MEDICAID 1801273321

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