Provider Demographics
NPI:1588344006
Name:PERKINS, KAMILLE BRIANA
Entity type:Individual
Prefix:
First Name:KAMILLE
Middle Name:BRIANA
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 1:1841 S CALUMET AVE APT 1310
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-4812
Mailing Address - Country:US
Mailing Address - Phone:773-569-2159
Mailing Address - Fax:
Practice Address - Street 1:1674 W BAKER RD STE A
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2285
Practice Address - Country:US
Practice Address - Phone:281-837-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife