Provider Demographics
NPI:1851410393
Name:PURSIFULL, JULIE LYNNETTE (MS)
Entity type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:LYNNETTE
Last Name:PURSIFULL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 STONEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-4409
Mailing Address - Country:US
Mailing Address - Phone:859-351-3062
Mailing Address - Fax:859-263-2649
Practice Address - Street 1:2315 STONEWOOD LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-4409
Practice Address - Country:US
Practice Address - Phone:859-351-3062
Practice Address - Fax:859-263-2649
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor