Provider Demographics
NPI:1376783266
Name:PERKINS, GINA MARIE (RN)
Entity Type:Individual
Prefix:MRS
First Name:GINA
Middle Name:MARIE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:GINA
Other - Middle Name:MARIE
Other - Last Name:CASLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:24 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:NY
Mailing Address - Zip Code:13135-1907
Mailing Address - Country:US
Mailing Address - Phone:315-506-0681
Mailing Address - Fax:
Practice Address - Street 1:24 SPRING ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:NY
Practice Address - Zip Code:13135-1907
Practice Address - Country:US
Practice Address - Phone:315-506-0681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY551619163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse