Provider Demographics
NPI:1326679358
Name:PURIFOY, NANNETTE ARLIEN
Entity Type:Individual
Prefix:
First Name:NANNETTE
Middle Name:ARLIEN
Last Name:PURIFOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANNETTE
Other - Middle Name:ARLIEN
Other - Last Name:PURIFOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MILLER
Mailing Address - Street 1:1219 K ST NW
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1801
Mailing Address - Country:US
Mailing Address - Phone:580-798-4523
Mailing Address - Fax:
Practice Address - Street 1:1219 K ST NW
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1801
Practice Address - Country:US
Practice Address - Phone:580-798-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-29
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator