Provider Demographics
NPI:1407894223
Name:PERDUE, CARLA HAY (NP)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:HAY
Last Name:PERDUE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CARLA
Other - Middle Name:JEAN
Other - Last Name:HAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:400 SW 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-8246
Mailing Address - Country:US
Mailing Address - Phone:940-325-7891
Mailing Address - Fax:940-328-6523
Practice Address - Street 1:200 SW 25TH AVE STE 300
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-8242
Practice Address - Country:US
Practice Address - Phone:940-328-6239
Practice Address - Fax:940-328-7051
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX236706363L00000X
TXAP103488363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX284707YMYXOtherMEDICARE PTAN
TX284707YMC1OtherMEDICARE PTAN