=====================================================
General NPI Number Information
=====================================================
NPI Number | 1295683944
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CAROLYN RUTH PERRY MSN, PMHNP-BC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/18/2026
-----------------------------------------------------
Last Update Date | 03/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 661 E MAIN ST
-----------------------------------------------------
City | PERU
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46970-2662
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-472-2519
-----------------------------------------------------
Fax | 765-400-4465
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 661 E MAIN ST
-----------------------------------------------------
City | PERU
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46970-2662
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 765-472-2519
-----------------------------------------------------
Fax | 765-400-4465
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | 28302077A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------