Provider Demographics
NPI:1225330368
Name:PERKINS, JEANNINE MICHELLE
Entity Type:Individual
Prefix:MS
First Name:JEANNINE
Middle Name:MICHELLE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JEANNINE
Other - Middle Name:MICHELLE
Other - Last Name:SCHULTE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1770 E ELDERBERRY ST
Mailing Address - Street 2:
Mailing Address - City:PAHRUMP
Mailing Address - State:NV
Mailing Address - Zip Code:89048-0790
Mailing Address - Country:US
Mailing Address - Phone:775-209-6213
Mailing Address - Fax:
Practice Address - Street 1:1770 E ELDERBERRY ST
Practice Address - Street 2:
Practice Address - City:PAHRUMP
Practice Address - State:NV
Practice Address - Zip Code:89048-0790
Practice Address - Country:US
Practice Address - Phone:775-209-6213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No172V00000XOther Service ProvidersCommunity Health Worker