Provider Demographics
NPI:1730610858
Name:PURKEY, HANNAH CLAIRE
Entity type:Individual
Prefix:
First Name:HANNAH CLAIRE
Middle Name:
Last Name:PURKEY
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 1:2965 EAST ST
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:CA
Mailing Address - Zip Code:96007-3481
Mailing Address - Country:US
Mailing Address - Phone:530-378-0486
Mailing Address - Fax:
Practice Address - Street 1:2965 EAST ST
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:CA
Practice Address - Zip Code:96007-3481
Practice Address - Country:US
Practice Address - Phone:530-378-0486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC7-0006527207Q00000X
DEC1-0013764207Q00000X
CAA174995207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine