Basic Information
| Provider Information | |||||||||
| NPI: | 1689127029 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERRINE | ||||||||
| FirstName: | RITA | ||||||||
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| Credential: | AGAC-NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7785 DEGOOD RD | ||||||||
| Address2: | |||||||||
| City: | OSTRANDER | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430619764 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7406669401 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6150 E BROAD ST | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432131574 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6145464621 | ||||||||
| FaxNumber: | 6145464536 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/02/2016 | ||||||||
| LastUpdateDate: | 09/23/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LG0600X | 307753 | OH | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology | 3747A0650X | N | Nursing Service Related Providers | Technician | Attendant Care Provider | 363LA2100X | 307753 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.