Provider Demographics
NPI:1376215194
Name:PURSLEY, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:PURSLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:553 BOG HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:WASSAIC
Mailing Address - State:NY
Mailing Address - Zip Code:12592-2532
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:553 BOG HOLLOW RD
Practice Address - Street 2:
Practice Address - City:WASSAIC
Practice Address - State:NY
Practice Address - Zip Code:12592-2532
Practice Address - Country:US
Practice Address - Phone:845-505-8534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-30
Last Update Date:2021-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY812365163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse