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General NPI Number Information
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NPI Number | 1396320628
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Entity Type | Individual
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Provider Name | NIKITA MARIE PERRY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 03/17/2021
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 705 GARFIELD AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-5444
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Country | US
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Telephone | 304-424-2085
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Fax |
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Provider Business Mailing Address
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Address Line | 705 GARFIELD AVE
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City | PARKERSBURG
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State | WV
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Zip | 26101-5444
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 108518
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 108518
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 108518
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License Number State | WV
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