Provider Demographics
NPI:1447363510
Name:PURCELL, MAUREEN K (PT)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:K
Last Name:PURCELL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:MAUREEN
Other - Middle Name:K
Other - Last Name:KELBEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:3600 W BETHEL AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-5407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:53880 CARMICHAEL DR
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635-1567
Practice Address - Country:US
Practice Address - Phone:574-247-9441
Practice Address - Fax:574-247-9442
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003074A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200876260Medicaid
IN000000508800OtherANTHEM BCBS