Provider Demographics
NPI:1386505774
Name:PERKINS, CHARLES JR (RN)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:PERKINS
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:509 ALOHA DR
Mailing Address - Street 2:
Mailing Address - City:LAKE HAVASU CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86406-4556
Mailing Address - Country:US
Mailing Address - Phone:308-432-5586
Mailing Address - Fax:800-245-6277
Practice Address - Street 1:160 CHADRON AVE
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2346
Practice Address - Country:US
Practice Address - Phone:308-432-5586
Practice Address - Fax:800-245-6277
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZRN165866163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse