Provider Demographics
NPI:1649854050
Name:PERRY, FLORA DELL
Entity type:Individual
Prefix:MS
First Name:FLORA
Middle Name:DELL
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 MOOREFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4509
Mailing Address - Country:US
Mailing Address - Phone:234-258-9447
Mailing Address - Fax:
Practice Address - Street 1:1645 MOOREFIELD AVE
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-4509
Practice Address - Country:US
Practice Address - Phone:234-258-9447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty