Provider Demographics
NPI:1245070416
Name:PERKINS, TANIKIA N (BS, MLS)
Entity type:Individual
Prefix:
First Name:TANIKIA
Middle Name:N
Last Name:PERKINS
Suffix:
Gender:F
Credentials:BS, MLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2738 BONNIE CREST CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36107-1129
Mailing Address - Country:US
Mailing Address - Phone:334-314-5691
Mailing Address - Fax:
Practice Address - Street 1:1565 E TRINITY BLVD # A5A6
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2897
Practice Address - Country:US
Practice Address - Phone:334-314-5691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL283278207ZP0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine