Provider Demographics
NPI:1548717267
Name:PURVIS, AMY ELIZABETH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ELIZABETH
Last Name:PURVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:ELIZABETH
Other - Last Name:REIGHTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:935 SHOTWELL RD
Mailing Address - Street 2:ST 108
Mailing Address - City:CLAYTON
Mailing Address - State:NC
Mailing Address - Zip Code:27520
Mailing Address - Country:US
Mailing Address - Phone:919-468-6820
Mailing Address - Fax:919-468-6484
Practice Address - Street 1:935 SHOTWELL RD
Practice Address - Street 2:ST 108
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520
Practice Address - Country:US
Practice Address - Phone:919-468-6820
Practice Address - Fax:919-468-6484
Is Sole Proprietor?:No
Enumeration Date:2016-09-10
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-06208363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical