MEDICARE: PATRICIA PERKINS NP

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	2279541	MA

General Provider Information

NPI Number	:	1982266011
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA PERKINS NP

Provider Business Mailing Address
First Line	:	271 CAREW ST
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01104-2377
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	299 CAREW ST STE 410
Second Line	:
City	:	SPRINGFIELD
State	:	MA
Zip	:	01104-2361
Country	:	US
Telephone Number	:	413-748-9628
Fax Number	:

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

Provider Enumeration Date	:	06/28/2019
Last Update Date	:	10/03/2019

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