Provider Demographics
NPI:1942826375
Name:PURKEYPILE, CLARISSA BUSSELL (DNP)
Entity Type:Individual
Prefix:MRS
First Name:CLARISSA
Middle Name:BUSSELL
Last Name:PURKEYPILE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:CLARISSA
Other - Middle Name:JOYE
Other - Last Name:BUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:11262 CAMPUS ST
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92350-1727
Mailing Address - Country:US
Mailing Address - Phone:803-260-6617
Mailing Address - Fax:
Practice Address - Street 1:11262 CAMPUS ST
Practice Address - Street 2:
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92350-1727
Practice Address - Country:US
Practice Address - Phone:803-260-6617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-22
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95018431363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology