Individual
ETHAN EMORY PERKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
4142 MILL ST NE, COVINGTON, GA 30014-2540
(770) 787-3550
Mailing address
4142 MILL ST NE, COVINGTON, GA 30014-2540
(770) 787-3550
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN280873
GA
Other
Enumeration date
04/20/2020
Last updated
02/02/2022
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