Provider Demographics
NPI:1225532666
Name:DJALI PURVIS, SARAH ASHLYN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SARAH
Middle Name:ASHLYN
Last Name:DJALI PURVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5904 SIX FORKS RD STE 211
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-8228
Mailing Address - Country:US
Mailing Address - Phone:984-242-0510
Mailing Address - Fax:984-242-0520
Practice Address - Street 1:5904 SIX FORKS RD STE 211
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-8228
Practice Address - Country:US
Practice Address - Phone:984-242-0510
Practice Address - Fax:984-242-0520
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-07970363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant