Provider Demographics
NPI:1821337049
Name:PERRAS, KIMBERLEE KRUGER (MS, RN, FNP-C)
Entity type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:KRUGER
Last Name:PERRAS
Suffix:
Gender:F
Credentials:MS, RN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 604050
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-4050
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:855 SAM NEWELL RD.
Practice Address - Street 2:SUITE 204
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-7594
Practice Address - Country:US
Practice Address - Phone:980-202-6643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP122753363LF0000X
NC5020009363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily