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General NPI Number Information
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NPI Number | 1639893597
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Entity Type | Individual
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Provider Name | SAMANTHA PERKINS PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/03/2022
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 75 PRINGLE WAY STE 1002
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City | RENO
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State | NV
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Zip | 89502-1475
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Country | US
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Telephone | 775-323-7500
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Fax | 775-789-9208
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Provider Business Mailing Address
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Address Line | 75 PRINGLE WAY STE 1002
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City | RENO
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State | NV
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Zip | 89502-1475
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Country | US
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Telephone | 775-323-7500
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Fax | 775-789-9208
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA2687
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License Number State | NV
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