Provider Demographics
NPI:1023348711
Name:PERKINS, MICHELLE IRENE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:IRENE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 IRVING PL
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-2332
Mailing Address - Country:US
Mailing Address - Phone:646-784-1439
Mailing Address - Fax:
Practice Address - Street 1:900 INTERVALE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-4204
Practice Address - Country:US
Practice Address - Phone:646-784-1439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-04
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF336096-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily