Provider Demographics
NPI:1265186415
Name:PERKINS, MEGHAN COLLEEN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MEGHAN
Middle Name:COLLEEN
Last Name:PERKINS
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:MS
Other - First Name:MEGHAN
Other - Middle Name:COLLEEN
Other - Last Name:DIETTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:143 W BROOKLINE ST APT 302
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-1599
Mailing Address - Country:US
Mailing Address - Phone:860-488-1691
Mailing Address - Fax:
Practice Address - Street 1:1832 CENTRE ST
Practice Address - Street 2:
Practice Address - City:WEST ROXBURY
Practice Address - State:MA
Practice Address - Zip Code:02132-1901
Practice Address - Country:US
Practice Address - Phone:617-469-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical