Provider Demographics
NPI:1225092356
Name:PURDUM, BARBARA A (CRNP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:PURDUM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:GRINDEL
Other - Last Name:PURDUM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNP
Mailing Address - Street 1:1850 E PARK AVE
Mailing Address - Street 2:STE 312
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-6706
Mailing Address - Country:US
Mailing Address - Phone:814-689-3156
Mailing Address - Fax:814-689-1954
Practice Address - Street 1:1850 E PARK AVE
Practice Address - Street 2:STE 312
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16803-6706
Practice Address - Country:US
Practice Address - Phone:814-689-3156
Practice Address - Fax:814-689-1954
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAUP006985B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner