Provider Demographics
NPI:1326234634
Name:PERRY, ROMEL G (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ROMEL
Middle Name:G
Last Name:PERRY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 VACATION WAY
Mailing Address - Street 2:
Mailing Address - City:MILLERS CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:28651-8005
Mailing Address - Country:US
Mailing Address - Phone:757-285-0780
Mailing Address - Fax:
Practice Address - Street 1:4550 N POINT PKWY STE 160
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022
Practice Address - Country:US
Practice Address - Phone:800-977-8915
Practice Address - Fax:800-977-8916
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-20
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20872363LF0000X
VA0024166105363LF0000X
NC5007414363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily