Provider Demographics
NPI:1437624830
Name:PURNELL, SAQUAN ANTHONY
Entity Type:Individual
Prefix:
First Name:SAQUAN
Middle Name:ANTHONY
Last Name:PURNELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 R ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-1918
Mailing Address - Country:US
Mailing Address - Phone:202-520-1490
Mailing Address - Fax:
Practice Address - Street 1:410 R ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-1918
Practice Address - Country:US
Practice Address - Phone:202-520-1490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion