Provider Demographics
NPI:1902422272
Name:PURPER, JONDA JANETTE
Entity Type:Individual
Prefix:
First Name:JONDA
Middle Name:JANETTE
Last Name:PURPER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8444
Mailing Address - Street 2:
Mailing Address - City:SPRING CREEK
Mailing Address - State:NV
Mailing Address - Zip Code:89815-0008
Mailing Address - Country:US
Mailing Address - Phone:435-835-3491
Mailing Address - Fax:
Practice Address - Street 1:164 MARTIN AVE
Practice Address - Street 2:
Practice Address - City:SPRING CREEK
Practice Address - State:NV
Practice Address - Zip Code:89815-8744
Practice Address - Country:US
Practice Address - Phone:435-835-3491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7000569-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse