Provider Demographics
NPI:1790276988
Name:PERRITT, JAMES (NP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:PERRITT
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 GREEN GROVE CT
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1469
Mailing Address - Country:US
Mailing Address - Phone:410-402-3043
Mailing Address - Fax:
Practice Address - Street 1:517 BENFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146-2527
Practice Address - Country:US
Practice Address - Phone:410-402-3043
Practice Address - Fax:410-824-5240
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR174143363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health