Provider Demographics
NPI:1649458142
Name:PURDY, DENISE DIANE
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:DIANE
Last Name:PURDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3901 PARKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-0509
Mailing Address - Country:US
Mailing Address - Phone:605-721-6732
Mailing Address - Fax:605-721-6733
Practice Address - Street 1:3901 PARKRIDGE DR
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-0509
Practice Address - Country:US
Practice Address - Phone:605-721-6732
Practice Address - Fax:605-721-6733
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies