Provider Demographics
NPI:1831070390
Name:TRICE-PURNELL, KERIAN (RN, BSN, CLC, CBE)
Entity type:Individual
Prefix:MRS
First Name:KERIAN
Middle Name:
Last Name:TRICE-PURNELL
Suffix:
Gender:F
Credentials:RN, BSN, CLC, CBE
Other - Prefix:
Other - First Name:KERIAN
Other - Middle Name:
Other - Last Name:TRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 CRYSTALWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-5397
Mailing Address - Country:US
Mailing Address - Phone:501-412-5013
Mailing Address - Fax:
Practice Address - Street 1:2 CRYSTALWOOD DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-5397
Practice Address - Country:US
Practice Address - Phone:501-412-5013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR103459163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty