Provider Demographics
NPI:1295116093
Name:PERRY, NAKIDA (STNA)
Entity type:Individual
Prefix:
First Name:NAKIDA
Middle Name:
Last Name:PERRY
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6822 WHITE CHAPEL CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-1582
Mailing Address - Country:US
Mailing Address - Phone:614-288-5334
Mailing Address - Fax:614-392-0213
Practice Address - Street 1:6822 WHITE CHAPEL CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1582
Practice Address - Country:US
Practice Address - Phone:614-288-5334
Practice Address - Fax:614-392-0213
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401703041114376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide