Provider Demographics
NPI:1558151241
Name:PERKINS, BRENDA KAY
Entity type:Individual
Prefix:
First Name:BRENDA
Middle Name:KAY
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
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 521103
Mailing Address - Street 2:
Mailing Address - City:BIG LAKE
Mailing Address - State:AK
Mailing Address - Zip Code:99652-1103
Mailing Address - Country:US
Mailing Address - Phone:907-350-0249
Mailing Address - Fax:888-512-2301
Practice Address - Street 1:20668 W. ANNA LAKE WAY
Practice Address - Street 2:
Practice Address - City:BIG LAKE
Practice Address - State:AK
Practice Address - Zip Code:99652-1103
Practice Address - Country:US
Practice Address - Phone:907-350-0249
Practice Address - Fax:888-512-2301
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator