Provider Demographics
NPI:1457082661
Name:PURKS, SANDRA MARIE (RN, PCCN)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:MARIE
Last Name:PURKS
Suffix:
Gender:F
Credentials:RN, PCCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 ALMSHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-1202
Mailing Address - Country:US
Mailing Address - Phone:215-219-3397
Mailing Address - Fax:
Practice Address - Street 1:980 ALMSHOUSE RD
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-1202
Practice Address - Country:US
Practice Address - Phone:215-219-3397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-19
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN640678163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse