Provider Demographics
NPI:1750721957
Name:PURCELL, KRISTA A (APRN)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:A
Last Name:PURCELL
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 1:601 SW CORPORATE VW STE 200
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66615-1245
Mailing Address - Country:US
Mailing Address - Phone:785-234-0880
Mailing Address - Fax:785-234-4150
Practice Address - Street 1:601 SW CORPORATE VW STE 200
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66615-1245
Practice Address - Country:US
Practice Address - Phone:785-234-0880
Practice Address - Fax:785-234-4150
Is Sole Proprietor?:No
Enumeration Date:2013-07-02
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76131363L00000X
KS76131363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS068002228OtherMEDICARE PTAN
KS201084090AMedicaid