Provider Demographics
NPI:1992311039
Name:PERKINS, AMY JO
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:JO
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 1:4094 HOPEWELL CHURCH RD SW
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8053
Mailing Address - Country:US
Mailing Address - Phone:740-409-1197
Mailing Address - Fax:
Practice Address - Street 1:1345 FULLER CT
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-7852
Practice Address - Country:US
Practice Address - Phone:740-785-5275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant