Healthcare Provider Details

I. General information

NPI: 1730150863
Provider Name (Legal Business Name): REBEKAH PERKS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

470 GRANBY RD RAYMOND MEDICAL CENTER
SOUTH HADLEY MA
01075-3218
US

IV. Provider business mailing address

RAYMOND MEDICAL CENTER 470 GRANBY RD
SOUTH HADLEY MA
01075
US

V. Phone/Fax

Practice location:
  • Phone: 413-533-7200
  • Fax: 413-794-8583
Mailing address:
  • Phone: 413-533-7200
  • Fax: 413-794-8583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number258361
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: