Provider Demographics
NPI:1598297517
Name:PERRY, KIERAN
Entity Type:Individual
Prefix:
First Name:KIERAN
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4637 BENNING RD SE
Mailing Address - Street 2:APT A
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-5156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4637 BENNING RD SE
Practice Address - Street 2:APT A
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-5156
Practice Address - Country:US
Practice Address - Phone:202-422-4341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant