Mildred Maurillo Purtell, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703101031 Issued in MI

Practice address

203 Dartmouth Dr
Midland, MI 48640-4513

Phone

(989) 839-2311

Fax

(800) 336-0596

NPI assigned

Dec 9, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wendy R White, LLC

  • Home Health Agency
  • Midland, MI
  • NPI 1386391563
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1144867102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 GREEN AVE",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086887",
            "telephone_number": "989-600-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 DARTMOUTH DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404513",
            "telephone_number": "989-839-2311",
            "fax_number": "800-336-0596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURTELL",
        "first_name": "MILDRED",
        "middle_name": "MAURILLO",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2023-11-27",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703101031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4703101031",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "PHOENIX",
            "affiliation": "Y",
            "endpointDescription": "Secure System",
            "affiliationName": "Carebuilders at Home, LLC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "manually entered into state system",
            "address_1": "203 Dartmouth Dr",
            "city": "Midland",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486404513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kim Pross, NURSE
• Victoria Pruitt, PT, DPT
• Kevin Gerard Przybylski, PHARM.D.
• Heather L Pugsley, BS
• Anudeep Adam Pulivarti
• Veronica Putnam, LLMSW
• Benjamin Putt
• Crystal Janice Putt, CPHT
• Olivia Pyorala
• Nusrat Qayyum, PA-C

• Licensed Practical Nurse in Midland, MI
• Providers in Midland, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.