Healthcare Provider Details

I. General information

NPI: 1477322139
Provider Name (Legal Business Name): KINA KYSONIA PERKINS NP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2023
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5306 NC HIGHWAY 55 STE 105
DURHAM NC
27713-7812
US

IV. Provider business mailing address

8601 SIX FORKS RD STE 412
RALEIGH NC
27615-5276
US

V. Phone/Fax

Practice location:
  • Phone: 919-457-1517
  • Fax: 919-363-7697
Mailing address:
  • Phone: 984-283-0333
  • Fax: 984-283-0433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5019450
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: