Provider Demographics
NPI:1386609568
Name:PERKINS, JUANITA FRAZIER (FNP)
Entity type:Individual
Prefix:MRS
First Name:JUANITA
Middle Name:FRAZIER
Last Name:PERKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 ELM ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-4152
Mailing Address - Country:US
Mailing Address - Phone:910-491-1089
Mailing Address - Fax:833-973-5477
Practice Address - Street 1:810 ELM ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4152
Practice Address - Country:US
Practice Address - Phone:910-491-1089
Practice Address - Fax:833-973-5477
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN085691363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner