Provider Demographics
NPI:1972199800
Name:PERKINS, JAMIE LEIGH
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEIGH
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7802 COUNTY ROAD 26
Mailing Address - Street 2:
Mailing Address - City:WEST MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43358-9527
Mailing Address - Country:US
Mailing Address - Phone:937-243-6870
Mailing Address - Fax:
Practice Address - Street 1:7802 COUNTY ROAD 26
Practice Address - Street 2:
Practice Address - City:WEST MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43358-9527
Practice Address - Country:US
Practice Address - Phone:937-243-6870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-15
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3747A0650X, 3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider