Provider Demographics
NPI:1588904759
Name:PERKINS, CONNIE MARIE (LM, CPM, BSM)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:MARIE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LM, CPM, BSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W AIPUNI PL
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-1865
Mailing Address - Country:US
Mailing Address - Phone:517-614-7756
Mailing Address - Fax:
Practice Address - Street 1:25 W AIPUNI PL
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-1865
Practice Address - Country:US
Practice Address - Phone:517-614-7756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-25
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMW-34-0176B00000X
176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife