Provider Demographics
NPI:1134881782
Name:PERKINS, KRISTEN ELLIS (APRN FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:ELLIS
Last Name:PERKINS
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 HIGHWAY 1023
Mailing Address - Street 2:
Mailing Address - City:LILY
Mailing Address - State:KY
Mailing Address - Zip Code:40740-3530
Mailing Address - Country:US
Mailing Address - Phone:606-682-4754
Mailing Address - Fax:
Practice Address - Street 1:2280 HIGHWAY 1023
Practice Address - Street 2:
Practice Address - City:LILY
Practice Address - State:KY
Practice Address - Zip Code:40740-3530
Practice Address - Country:US
Practice Address - Phone:606-682-4754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1120298163W00000X
KY3016823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse