Healthcare Provider Details

I. General information

NPI: 1073437356
Provider Name (Legal Business Name): JAMIE PERKINS KHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE LEIGH PERKINS RN

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 E D ST
LEMOORE CA
93245-9545
US

IV. Provider business mailing address

3732 W WOODSIDE AVE
VISALIA CA
93291-5562
US

V. Phone/Fax

Practice location:
  • Phone: 559-924-7711
  • Fax:
Mailing address:
  • Phone: 410-980-9914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95040912
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: