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General NPI Number Information
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NPI Number | 1629895602
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Entity Type | Organization
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Legal Business Name | PERFECTLY M PERFECT
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Dates
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Enumeration Date | 09/23/2024
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 4109 E NORTH ST STE 300C
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City | GREENVILLE
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State | SC
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Zip | 29615-6227
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Country | US
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Telephone | 864-409-7041
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Fax | 864-428-1286
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Provider Business Mailing Address
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Address Line | 4109 E NORTH ST STE 300C
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City | GREENVILLE
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State | SC
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Zip | 29615-6227
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Country | US
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Telephone | 864-409-7041
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Fax | 864-428-1286
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISSIE MIDDLETON
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Credential |
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Telephone | 864-630-1126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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