Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 3011200 | KY |
NPI | 1003335050 |
---|---|
Provider Name | Kathryn Alexis Perkins |
First Address | Cleves, OH 45002-4707 |
Second Address | Highland Heights, KY 41076-9753 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2017 |
Last Update Date | 11/09/2017 |