Provider Demographics
NPI:1154389195
Name:PURTEE, PAULA JILL (RNP)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JILL
Last Name:PURTEE
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10750 W MCDOWELL RD
Mailing Address - Street 2:SUITE G700
Mailing Address - City:AVONDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85392-5960
Mailing Address - Country:US
Mailing Address - Phone:623-873-0321
Mailing Address - Fax:623-849-9623
Practice Address - Street 1:10750 W MCDOWELL RD
Practice Address - Street 2:SUITE G700
Practice Address - City:AVONDALE
Practice Address - State:AZ
Practice Address - Zip Code:85392-5960
Practice Address - Country:US
Practice Address - Phone:623-873-0321
Practice Address - Fax:623-849-9623
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR43547163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXT8613Medicaid
AZ518948Medicaid