Provider Demographics
NPI:1043445109
Name:PERRYMAN, YOLANDA DENISE (RN)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:DENISE
Last Name:PERRYMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 JANET DAVIS CIR
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:MS
Mailing Address - Zip Code:38751-3754
Mailing Address - Country:US
Mailing Address - Phone:662-207-4357
Mailing Address - Fax:
Practice Address - Street 1:319 JANET DAVIS CIR
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-3754
Practice Address - Country:US
Practice Address - Phone:662-207-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR879003163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse