Provider Demographics
NPI:1306379656
Name:PERRYMAN, ERIN ALLESSE (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:ALLESSE
Last Name:PERRYMAN
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12750 DOWNING ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48217-1004
Mailing Address - Country:US
Mailing Address - Phone:313-550-0803
Mailing Address - Fax:
Practice Address - Street 1:12750 DOWNING ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48217-1004
Practice Address - Country:US
Practice Address - Phone:313-550-0803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704314952163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse