Provider Demographics
NPI:1003402223
Name:PERKINS, CHRISTINE CHARMAINE
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:CHARMAINE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 396
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-0396
Mailing Address - Country:US
Mailing Address - Phone:610-357-9820
Mailing Address - Fax:
Practice Address - Street 1:122 POWELTON AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-1611
Practice Address - Country:US
Practice Address - Phone:610-357-9820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-13
Last Update Date:2020-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN313876164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse