Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 0101052952 | VA |
Y | 208600000X | Surgeon | 0101052952 | VA |
NPI | 1023077435 |
---|---|
Provider Name | Dr. Shelley Kathleen Perkins |
First Address | Oceanside, CA 92058-1008 |
Second Address | Portsmouth, VA 23708-2111 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 10/05/2021 |