Provider Demographics
NPI:1932568102
Name:PERKS, PATTI
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:
Last Name:PERKS
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 1:1604 CALVARY CIR
Mailing Address - Street 2:APT 404
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8461
Mailing Address - Country:US
Mailing Address - Phone:434-243-1411
Mailing Address - Fax:
Practice Address - Street 1:1604 CALVARY CIR
Practice Address - Street 2:APT 404
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8461
Practice Address - Country:US
Practice Address - Phone:434-243-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-17
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric