Basic Information
| Provider Information | |||||||||
| NPI: | 1760421358 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PERKINS | ||||||||
| FirstName: | AUBREY | ||||||||
| MiddleName: | N | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5579 | ||||||||
| Address2: | |||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977085579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417064800 | ||||||||
| FaxNumber: | 5417064806 | ||||||||
| Practice Location | |||||||||
| Address1: | 2965 NE CONNERS AVE STE 127 | ||||||||
| Address2: | |||||||||
| City: | BEND | ||||||||
| State: | OR | ||||||||
| PostalCode: | 977017753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5417064800 | ||||||||
| FaxNumber: | 5417064806 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 02/05/2016 | ||||||||
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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 | 363LF0000X | 50127 | OR | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 500604901 | 05 | OR | MEDICAID | 306349600 | 05 | FL | MEDICAID |