Provider Demographics
NPI:1003335050
Name:PERKINS, KATHRYN ALEXIS (CPNP)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ALEXIS
Last Name:PERKINS
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8820 CORONET CT
Mailing Address - Street 2:
Mailing Address - City:CLEVES
Mailing Address - State:OH
Mailing Address - Zip Code:45002-4707
Mailing Address - Country:US
Mailing Address - Phone:513-207-1726
Mailing Address - Fax:
Practice Address - Street 1:1016 TOWN DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND HEIGHTS
Practice Address - State:KY
Practice Address - Zip Code:41076-9753
Practice Address - Country:US
Practice Address - Phone:859-441-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-11
Last Update Date:2017-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3011200363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics