Provider Demographics
NPI:1841533353
Name:PURVIS, FRANCIS ARDEN JACKSON (PA-C)
Entity type:Individual
Prefix:MRS
First Name:FRANCIS ARDEN
Middle Name:JACKSON
Last Name:PURVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:FRANCIS
Other - Middle Name:ARDEN
Other - Last Name:JACKSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3635 VISTA AVE
Mailing Address - Street 2:TRANSPLANT SERVICES
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2539
Mailing Address - Country:US
Mailing Address - Phone:314-577-8867
Mailing Address - Fax:314-268-5133
Practice Address - Street 1:3660 VISTA AVE
Practice Address - Street 2:SUITES 302, 308
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-2540
Practice Address - Country:US
Practice Address - Phone:314-577-8867
Practice Address - Fax:314-268-5133
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013009607363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant