Healthcare Provider Details

I. General information

NPI: 1487903936
Provider Name (Legal Business Name): AMY M. PERKINS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMY M. GASKINS FNP-C

II. Dates (important events)

Enumeration Date: 08/30/2012
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8995 W COMMERCE ST STE 4
HERNANDO MS
38632-6812
US

IV. Provider business mailing address

8995 W COMMERCE ST STE 4
HERNANDO MS
38632-6812
US

V. Phone/Fax

Practice location:
  • Phone: 901-361-5746
  • Fax:
Mailing address:
  • Phone: 662-589-6290
  • Fax: 662-649-6085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number879057
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0712103
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: