Provider Demographics
NPI:1033271531
Name:PERKINS, MARIE S (RN, CRNA)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:S
Last Name:PERKINS
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:PA
Mailing Address - Zip Code:15344-4178
Mailing Address - Country:US
Mailing Address - Phone:724-883-4102
Mailing Address - Fax:
Practice Address - Street 1:750 E BEAU ST
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-6661
Practice Address - Country:US
Practice Address - Phone:724-228-7477
Practice Address - Fax:724-228-6271
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN113920L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered