Healthcare Provider Details

I. General information

NPI: 1922525146
Provider Name (Legal Business Name): KORINNE ELISE PERRY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2017
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

G3169 BEECHER RD
FLINT MI
48532-3611
US

IV. Provider business mailing address

G3169 BEECHER RD
FLINT MI
48532-3611
US

V. Phone/Fax

Practice location:
  • Phone: 616-301-8000
  • Fax: 810-744-1306
Mailing address:
  • Phone: 616-301-8000
  • Fax: 810-744-1306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601008339
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: