Provider Demographics
NPI:1467772558
Name:PURNELL, CANDICE (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:CANDICE
Middle Name:
Last Name:PURNELL
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 ROLLING RD
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-3625
Mailing Address - Country:US
Mailing Address - Phone:702-257-7403
Mailing Address - Fax:
Practice Address - Street 1:8310 ROLLING RD
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-3625
Practice Address - Country:US
Practice Address - Phone:702-257-7403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula