Provider Demographics
NPI:1255841623
Name:PERKINS, SHARON DENISE
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:DENISE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4855 VEGAS VALLEY DR APT 277
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89121-2083
Mailing Address - Country:US
Mailing Address - Phone:702-336-9032
Mailing Address - Fax:
Practice Address - Street 1:3656 N RANCHO DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3172
Practice Address - Country:US
Practice Address - Phone:702-916-2840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health