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Individual

SHURIKA LYDEL PERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1533 CHESTER BLVD, RICHMOND, IN 47374-1914
(317) 319-2514
Mailing address
1533 CHESTER BLVD, RICHMOND, IN 47374-1914
(317) 319-2514

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10001424A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000779072
ANTHEM
IN
Enumeration date
07/05/2012
Last updated
02/18/2015
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