Provider Demographics
NPI:1366163107
Name:PERKINS, PENNY LEONE (FNP-BC, FNP-C)
Entity type:Individual
Prefix:
First Name:PENNY
Middle Name:LEONE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:FNP-BC, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8009 BOARD DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70817-6050
Mailing Address - Country:US
Mailing Address - Phone:225-614-5030
Mailing Address - Fax:
Practice Address - Street 1:16158 AIRLINE HWY STE 103
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-4222
Practice Address - Country:US
Practice Address - Phone:225-963-9355
Practice Address - Fax:225-314-9355
Is Sole Proprietor?:No
Enumeration Date:2022-09-09
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA227104363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily