Provider Demographics
NPI:1174019400
Name:PERRY, KARLI L (PAC)
Entity Type:Individual
Prefix:
First Name:KARLI
Middle Name:L
Last Name:PERRY
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:KARLI
Other - Middle Name:
Other - Last Name:STURGILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:158 TAYLOR BLVD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:OH
Mailing Address - Zip Code:44050-9300
Mailing Address - Country:US
Mailing Address - Phone:440-346-2715
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-1063
Practice Address - Country:US
Practice Address - Phone:440-695-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005599RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant