1821252065 NPI number — MEREDITH L PURGASON APRN, FNP

Table of content: MEREDITH L PURGASON APRN, FNP (NPI 1821252065)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821252065 NPI number — MEREDITH L PURGASON APRN, FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PURGASON
Provider First Name:
MEREDITH
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN, FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1821252065
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1330 BOILING SPRINGS RD
Provider Second Line Business Mailing Address:
STE 1600
Provider Business Mailing Address City Name:
SPARTANBURG
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29303-4219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-797-6044
Provider Business Mailing Address Fax Number:
864-797-6198

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 BRENDAN WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29615-3514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-385-7070
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/16/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  3644 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)