MEDICARE: CHARLOTTE L PERRY ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	53-75341	KS

General Provider Information

NPI Number	:	1184911893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLOTTE L PERRY ARNP

Provider Business Mailing Address
First Line	:	DEPT CH 14389
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60055-4389
Country	:	US
Telephone Number	:	785-295-5307
Fax Number	:	785-270-7646

Provider Business Practice Location Address
First Line	:	4646 NW FIELDING RD
Second Line	:
City	:	TOPEKA
State	:	KS
Zip	:	66618-2588
Country	:	US
Telephone Number	:	785-286-4475
Fax Number	:	785-286-4423

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2011
Last Update Date	:	07/01/2011

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