Provider Demographics
NPI:1396970158
Name:TODD A PERKINS APRN LLC
Entity type:Organization
Organization Name:TODD A PERKINS APRN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:860-276-3000
Mailing Address - Street 1:26 N MAIN ST
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2572
Mailing Address - Country:US
Mailing Address - Phone:860-276-3000
Mailing Address - Fax:860-276-3002
Practice Address - Street 1:26 N MAIN ST
Practice Address - Street 2:SUITE 2A
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2572
Practice Address - Country:US
Practice Address - Phone:860-276-3000
Practice Address - Fax:860-276-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003219251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health