Provider Demographics
NPI:1952412132
Name:PERKINS, JAYNE LENOR (APN)
Entity Type:Individual
Prefix:MRS
First Name:JAYNE
Middle Name:LENOR
Last Name:PERKINS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2605 POTOMAC DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4529
Mailing Address - Country:US
Mailing Address - Phone:713-784-1260
Mailing Address - Fax:
Practice Address - Street 1:2605 POTOMAC DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4529
Practice Address - Country:US
Practice Address - Phone:713-784-1260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX542600363LP0808X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX889N77OtherBC/BS
TX037963802Medicaid
TXS43410Medicare UPIN
TXTXB162747Medicare PIN