Provider Demographics
NPI:1962215921
Name:PERKINS, LANISHA R
Entity type:Individual
Prefix:
First Name:LANISHA
Middle Name:R
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 1:3930 14TH ST APT 102
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48208-2188
Mailing Address - Country:US
Mailing Address - Phone:313-471-8551
Mailing Address - Fax:
Practice Address - Street 1:3930 14TH ST APT 102
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48208-2188
Practice Address - Country:US
Practice Address - Phone:313-471-8551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-31
Last Update Date:2025-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide