Provider Demographics
NPI:1508201377
Name:PERRON, TINA ANN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:TINA
Middle Name:ANN
Last Name:PERRON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 PINEHILL RD
Mailing Address - Street 2:
Mailing Address - City:JENA
Mailing Address - State:LA
Mailing Address - Zip Code:71342-4137
Mailing Address - Country:US
Mailing Address - Phone:318-992-7604
Mailing Address - Fax:318-992-1214
Practice Address - Street 1:830 PINEHILL RD
Practice Address - Street 2:
Practice Address - City:JENA
Practice Address - State:LA
Practice Address - Zip Code:71342-4137
Practice Address - Country:US
Practice Address - Phone:318-992-7604
Practice Address - Fax:318-992-1214
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP06916363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily