Provider Demographics
NPI:1588967012
Name:PERRY, LORNA FAYE (LPN)
Entity type:Individual
Prefix:
First Name:LORNA
Middle Name:FAYE
Last Name:PERRY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:LORNA
Other - Middle Name:FAYE
Other - Last Name:JENKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:27642 US HIGHWAY 98
Mailing Address - Street 2:APT 622
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4843
Mailing Address - Country:US
Mailing Address - Phone:251-210-4437
Mailing Address - Fax:
Practice Address - Street 1:27642 US HIGHWAY 98
Practice Address - Street 2:APT 622
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4843
Practice Address - Country:US
Practice Address - Phone:251-210-4437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL0046354164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse