Provider Demographics
NPI:1760421358
Name:PERKINS, AUBREY N (FNP)
Entity Type:Individual
Prefix:
First Name:AUBREY
Middle Name:N
Last Name:PERKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5579
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97708-5579
Mailing Address - Country:US
Mailing Address - Phone:541-706-4800
Mailing Address - Fax:541-706-4806
Practice Address - Street 1:2965 NE CONNERS AVE STE 127
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7753
Practice Address - Country:US
Practice Address - Phone:541-706-4800
Practice Address - Fax:541-706-4806
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR50127363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500604901Medicaid
FL306349600Medicaid
FLU2640AMedicare ID - Type Unspecified
FL306349600Medicaid
ORR157451Medicare PIN