Provider Demographics
NPI:1912453226
Name:PERKINS, LAURIE (CNA)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 SADDLE OAK TRL
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34241-8514
Mailing Address - Country:US
Mailing Address - Phone:360-286-5955
Mailing Address - Fax:
Practice Address - Street 1:4901 SADDLE OAK TRL
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34241-8514
Practice Address - Country:US
Practice Address - Phone:360-286-5955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-27
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA 338093376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide