1811905615 NPI number — CLAUDIA T PERKINS FNP, ACNP

Table of content: CLAUDIA T PERKINS FNP, ACNP (NPI 1811905615)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811905615 NPI number — CLAUDIA T PERKINS FNP, ACNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PERKINS
Provider First Name:
CLAUDIA
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP, ACNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FULTON
Provider Other First Name:
CLAUDIA
Provider Other Middle Name:
P.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1811905615
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10399
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24543-5007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-792-3730
Provider Business Mailing Address Fax Number:
434-797-4150

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 RISON ST
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
DANVILLE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24541-2425
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-792-3730
Provider Business Practice Location Address Fax Number:
434-792-6048
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2100X , with the licence number:  0024077838 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: 0017000878 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 10011479N . This is a "SENTARA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010395763 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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