Provider Demographics
NPI:1053813501
Name:PURNELL, BARBARA M (CNM)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:M
Last Name:PURNELL
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1176 N COUNTY RD 300 W
Mailing Address - Street 2:
Mailing Address - City:BRAZIL
Mailing Address - State:IN
Mailing Address - Zip Code:47834-7499
Mailing Address - Country:US
Mailing Address - Phone:812-864-2026
Mailing Address - Fax:
Practice Address - Street 1:1176 N COUNTY RD 300 W
Practice Address - Street 2:
Practice Address - City:BRAZIL
Practice Address - State:IN
Practice Address - Zip Code:47834-7499
Practice Address - Country:US
Practice Address - Phone:812-864-2026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28118188A163W00000X
IN09000304A176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse