Provider Demographics
NPI:1164926069
Name:PERKINS, JULIETTE (RN)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:
Last Name:PERKINS
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 1:289 GREAT RD STE G1
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-4766
Mailing Address - Country:US
Mailing Address - Phone:978-679-1200
Mailing Address - Fax:978-486-2682
Practice Address - Street 1:289 GREAT RD STE G1
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-4766
Practice Address - Country:US
Practice Address - Phone:978-679-1200
Practice Address - Fax:978-486-2682
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN230295163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MARN230295OtherREGISTERED NURSE LICENSE