Provider Demographics
NPI:1790284677
Name:PURDY, ABBIE LYNN
Entity Type:Individual
Prefix:
First Name:ABBIE
Middle Name:LYNN
Last Name:PURDY
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 1:1601 E IMHOFF RD APT 1101
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4069
Mailing Address - Country:US
Mailing Address - Phone:580-628-1218
Mailing Address - Fax:
Practice Address - Street 1:1601 E IMHOFF RD APT 1101
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-4069
Practice Address - Country:US
Practice Address - Phone:580-628-1218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-06
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator