Individual
MRS. IDA TEOFILO PERKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
436 & 5TH TED STEVENS WAY, KOTZEBUE, AK 99752
(907) 442-7443
Mailing address
733 2ND AVE, KOTZEBUE, AK 99752
(907) 442-7443
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
6518
AK
164W00000X
Licensed Practical Nurse
LPN 14579
HI
164X00000X
Licensed Vocational Nurse
VN 188489
CA
Other
Enumeration date
03/18/2009
Last updated
03/18/2009
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