MEDICARE: MRS. EMILY DAVIS PERKINS F.N.P.

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	R860217	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1700019478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EMILY DAVIS PERKINS F.N.P.

Provider Business Mailing Address
First Line	:	PO BOX 470
Second Line	:
City	:	LOUISVILLE
State	:	MS
Zip	:	39339-0470
Country	:	US
Telephone Number	:	662-773-6211
Fax Number	:	662-446-1039

Provider Business Practice Location Address
First Line	:	106 W MAIN ST
Second Line	:
City	:	LOUISVILLE
State	:	MS
Zip	:	39339-2620
Country	:	US
Telephone Number	:	662-773-5704
Fax Number	:	662-773-9463

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

Provider Enumeration Date	:	08/28/2009
Last Update Date	:	08/06/2015

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