Provider Demographics
NPI:1063247286
Name:PURCELL, KIMBERLY KATE (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KATE
Last Name:PURCELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 OLD NORTH RD
Mailing Address - Street 2:
Mailing Address - City:WYOMING
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1237
Mailing Address - Country:US
Mailing Address - Phone:302-697-3207
Mailing Address - Fax:302-697-4963
Practice Address - Street 1:5 OLD NORTH RD
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:DE
Practice Address - Zip Code:19934-1237
Practice Address - Country:US
Practice Address - Phone:302-697-3207
Practice Address - Fax:302-697-4963
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0052479163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool