Provider Demographics
NPI:1073771291
Name:PERKINS, DARLETTE R (LPN)
Entity Type:Individual
Prefix:
First Name:DARLETTE
Middle Name:R
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 PINE ST
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:GA
Mailing Address - Zip Code:30467-2036
Mailing Address - Country:US
Mailing Address - Phone:912-564-1282
Mailing Address - Fax:912-564-7887
Practice Address - Street 1:416 PINE ST
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:GA
Practice Address - Zip Code:30467-2036
Practice Address - Country:US
Practice Address - Phone:912-564-1282
Practice Address - Fax:912-564-7887
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN025413164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse