Provider Demographics
NPI:1265678932
Name:PURVIS, SUSAN BRYANT (APRN)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:BRYANT
Last Name:PURVIS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W MULBERRY BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31407-3507
Mailing Address - Country:US
Mailing Address - Phone:912-350-5937
Mailing Address - Fax:912-273-1033
Practice Address - Street 1:101 W MULBERRY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31407-3507
Practice Address - Country:US
Practice Address - Phone:912-350-5937
Practice Address - Fax:912-273-1033
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN2209982363LW0102X, 363LX0001X
GARN330666363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology