Provider Demographics
NPI:1063666576
Name:PERKINS, LILLIAN SEINI (CRNA)
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:SEINI
Last Name:PERKINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LILLIAN
Other - Middle Name:SEINI
Other - Last Name:CLOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 N LIBERTY ST STE 300
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-8729
Mailing Address - Country:US
Mailing Address - Phone:208-991-5293
Mailing Address - Fax:866-269-1712
Practice Address - Street 1:900 N LIBERTY ST STE 300
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-8729
Practice Address - Country:US
Practice Address - Phone:208-991-5293
Practice Address - Fax:866-269-1712
Is Sole Proprietor?:No
Enumeration Date:2008-11-11
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693742367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered