Basic Information
Provider Information
NPI: 1992213763
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PERKINS
FirstName: KAREN
MiddleName: W
NamePrefix:  
NameSuffix:  
Credential: R.N.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: WARF
OtherFirstName: KAREN
OtherMiddleName: JO
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: 6350 W ANDREW JOHNSON HWY DEPT 100
Address2:  
City: TALBOTT
State: TN
PostalCode: 378778605
CountryCode: US
TelephoneNumber: 8003553565
FaxNumber: 4237142355
Practice Location
Address1: 2574 FRAYSER BLVD
Address2:  
City: MEMPHIS
State: TN
PostalCode: 381275829
CountryCode: US
TelephoneNumber: 9013024361
FaxNumber: 8653420121
Other Information
ProviderEnumerationDate: 01/16/2018
LastUpdateDate: 01/16/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN125484TNY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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