Healthcare Provider Details

I. General information

NPI: 1356658488
Provider Name (Legal Business Name): STEPHEN MATTHEW PERKEY CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2010
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 SAINT CHRISTOPHER DR STE 321
ASHLAND KY
41101-7087
US

IV. Provider business mailing address

401 ORCHARD DR
SOUTH POINT OH
45680-8406
US

V. Phone/Fax

Practice location:
  • Phone: 606-329-8588
  • Fax:
Mailing address:
  • Phone: 740-861-1926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCOA.14610-NP
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number102732
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: