Individual
CHARLES AUSTIN PERRY II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
210 E GRAY ST, SUITE 1105, LOUISVILLE, KY 40202-3900
(502) 583-1697
(502) 583-2120
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007332
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000764051
ANTHEM - NNIKY
KY
01
—
134996
SIHO - NNIKY
KY
05
—
201067550
—
IN
01
—
50038650
PASSPORT - NNIKY
KY
05
—
7100201270
—
KY
Enumeration date
03/12/2012
Last updated
01/21/2021
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