Healthcare Provider Details

I. General information

NPI: 1790902351
Provider Name (Legal Business Name): NATALIE ANGELE PERKINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 W. HIGHLAND AVE
SAN BERNARDINO CA
92405
US

IV. Provider business mailing address

742 W. HIGHLAND AVE
SAN BERNARDINO CA
92405
US

V. Phone/Fax

Practice location:
  • Phone: 909-881-7320
  • Fax: 909-881-7329
Mailing address:
  • Phone: 909-881-7320
  • Fax: 909-881-7329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number531555
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: