Provider Demographics
NPI:1629123153
Name:PERKINS, JEANANN LORANGER (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JEANANN
Middle Name:LORANGER
Last Name:PERKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:JEAN
Other - Middle Name:ANN
Other - Last Name:LORANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:600 HANGAR AVE, BLDG 2040, RM 4
Mailing Address - Street 2:624TH ASTS
Mailing Address - City:HICKAM AFB
Mailing Address - State:HI
Mailing Address - Zip Code:96853-5272
Mailing Address - Country:US
Mailing Address - Phone:808-448-7803
Mailing Address - Fax:808-448-3113
Practice Address - Street 1:600 HANGAR AVE, BLDG 2040, RM 4
Practice Address - Street 2:624TH ASTS
Practice Address - City:HICKAM AFB
Practice Address - State:HI
Practice Address - Zip Code:96853-5272
Practice Address - Country:US
Practice Address - Phone:808-448-7803
Practice Address - Fax:808-448-3113
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical