| Doctor Name: | DIANE PURSE |
| NPI Number: | 1427171925 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 105532 |
| Business Practice Address: | 320 Beard Creek Road Edwards, CO - 81632 |
| Business Phone Number: | 9709452840 |
| Business Fax Number: | 9709452893 |
| Mailing Address: | 320 Beard Creek Road, EDWARDS |
| State: | CO |
| Postal Code: | 81632 |
| Phone Number: | 9709452840 |
| Fax Number: | 9709452893 |
| NPI Enumeration Date: | 04/09/2007 |
| NPI Last Update Date: | 01/04/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 105532 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |