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General NPI Number Information
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NPI Number | 1194068924
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Entity Type | Individual
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Provider Name | AMANDA MARIE PERKINS C.R.N.A.
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Gender | Female
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Dates
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Enumeration Date | 03/29/2013
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Last Update Date | 03/03/2022
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Provider Practice Location Address
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Address Line | 5336 STADIUM TRACE PKWY SUITE 104
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City | HOOVER
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State | AL
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Zip | 35244-4580
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Country | US
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Telephone | 205-958-5394
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Fax |
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Provider Business Mailing Address
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Address Line | 2964 KELHAM GROVE WAY
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City | BIRMINGHAM
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State | AL
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Zip | 35242-6715
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Country | US
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Telephone | 479-372-2478
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R081462
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-128896
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1-128896
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License Number State | AL
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