Provider Demographics
NPI:1942971288
Name:PERLMAN, ANDREW DAVID (AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:DAVID
Last Name:PERLMAN
Suffix:
Gender:M
Credentials:AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 MARY LN
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-5304
Mailing Address - Country:US
Mailing Address - Phone:478-714-8455
Mailing Address - Fax:
Practice Address - Street 1:118 MARY LN
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-5304
Practice Address - Country:US
Practice Address - Phone:478-714-8455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN264420363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner