Provider Demographics
NPI:1760425748
Name:PERKINS, MELISSA A (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:PERKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:RODGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:131 SAUNDERSVILLE RD
Mailing Address - Street 2:STE 160
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075
Mailing Address - Country:US
Mailing Address - Phone:615-824-3737
Mailing Address - Fax:888-295-0304
Practice Address - Street 1:353 NEW SHACKLE ISLAND RD
Practice Address - Street 2:STE 122B
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-2379
Practice Address - Country:US
Practice Address - Phone:615-824-3737
Practice Address - Fax:888-295-0304
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000001099363A00000X
GA004869363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3662051Medicaid
TN4118930OtherBCBSTN
TNP00331092Medicare PIN
Q02248Medicare UPIN
TN3662051Medicare PIN
TN3662051Medicaid