Provider Demographics
NPI:1124160197
Name:PERRIER, KATHLEAN Y (ANP-C)
Entity type:Individual
Prefix:
First Name:KATHLEAN
Middle Name:Y
Last Name:PERRIER
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 N FORBES BLVD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85745-1412
Mailing Address - Country:US
Mailing Address - Phone:520-872-7265
Mailing Address - Fax:520-872-7929
Practice Address - Street 1:395 N SILVERBELL RD
Practice Address - Street 2:SUITE 355
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2656
Practice Address - Country:US
Practice Address - Phone:520-622-5912
Practice Address - Fax:520-791-2246
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2009-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN055663363LA2200X
AZAP0058363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ760513Medicaid
AZ760513Medicaid