Provider Demographics
NPI:1922378561
Name:PERKINS, DANIEL PAUL
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:PERKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6112 MAIN ST APT 6
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-6992
Mailing Address - Country:US
Mailing Address - Phone:541-726-2440
Mailing Address - Fax:
Practice Address - Street 1:6112 MAIN ST APT 6
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-6992
Practice Address - Country:US
Practice Address - Phone:541-726-2440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-11
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200441428RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse