MEDICARE: MRS. BRANDY R PERKINS NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	COA.12721-NP	OH
2	363LF0000X	Family Nurse Practitioner	5017109	NC

General Provider Information

NPI Number	:	1144504101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BRANDY R PERKINS NP-C

Provider Business Mailing Address
First Line	:	PO BOX 68
Second Line	:
City	:	POLLOCKSVILLE
State	:	NC
Zip	:	28573-0068
Country	:	US
Telephone Number	:	252-808-0145
Fax Number	:	252-808-2770

Provider Business Practice Location Address
First Line	:	4252 ARENDELL ST
Second Line	:
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-0010
Country	:	US
Telephone Number	:	252-808-0145
Fax Number	:	252-808-2770

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2011
Last Update Date	:	11/02/2022

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