MEDICARE: LAURIE PERKINS CNA

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	376K00000X	Nurse's Aide	CNA 338093	FL

General Provider Information

NPI Number	:	1912453226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE PERKINS CNA

Provider Business Mailing Address
First Line	:	4901 SADDLE OAK TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34241-8514
Country	:	US
Telephone Number	:	360-286-5955
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 SADDLE OAK TRL
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34241-8514
Country	:	US
Telephone Number	:	360-286-5955
Fax Number	:

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

Provider Enumeration Date	:	08/27/2016
Last Update Date	:	08/27/2016

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