Provider Demographics
NPI:1336374990
Name:PERKINS, GLORIA JEAN (NP)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:JEAN
Last Name:PERKINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3157 SHERWOOD OAKS LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-5457
Mailing Address - Country:US
Mailing Address - Phone:770-314-2895
Mailing Address - Fax:404-778-5121
Practice Address - Street 1:1365B CLIFTON RD NE STE 2200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-778-3129
Practice Address - Fax:404-778-5121
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN 096269363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner