Provider Demographics
NPI:1568098630
Name:PURNELL, BRIANNA LONTAI (RN)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:LONTAI
Last Name:PURNELL
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:146 BLACK SPRINGS RD NE
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-7552
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:280 PATTONSVILLE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:OH
Practice Address - Zip Code:45640-9452
Practice Address - Country:US
Practice Address - Phone:855-446-5937
Practice Address - Fax:740-441-8058
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2022-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
OHAPRN.CRNA.0020563367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program