Provider Demographics
NPI:1336150010
Name:PERKINS, HILAH SUE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:HILAH
Middle Name:SUE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3810
Mailing Address - Street 2:
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64803-3810
Mailing Address - Country:US
Mailing Address - Phone:417-347-3474
Mailing Address - Fax:417-347-0190
Practice Address - Street 1:1201 E CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6623
Practice Address - Country:US
Practice Address - Phone:620-231-0958
Practice Address - Fax:620-231-1238
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006020756363LA2200X
KS45438363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100189710BMedicaid
KSP76354Medicare UPIN
KS100189710BMedicaid