Basic Information
| Provider Information | |||||||||
| NPI: | 1942676911 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PERKINS | ||||||||
| FirstName: | KATHERINE | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | APRN/PNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6002 SHALLOW BROOK LN | ||||||||
| Address2: | |||||||||
| City: | ZACHARY | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707912787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2252785754 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3501 HIGHWAY 10 | ||||||||
| Address2: | |||||||||
| City: | JACKSON | ||||||||
| State: | LA | ||||||||
| PostalCode: | 707486238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2256831360 | ||||||||
| FaxNumber: | 2256340005 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/13/2015 | ||||||||
| LastUpdateDate: | 05/01/2019 | ||||||||
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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 | 363LP0200X | AP08223 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 2403605 | 05 | LA | MEDICAID | 08254849 | 05 | MS | MEDICAID |