Provider Demographics
NPI:1548691876
Name:PERKINS, HEATH WEBB (CRNA)
Entity type:Individual
Prefix:MR
First Name:HEATH
Middle Name:WEBB
Last Name:PERKINS
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Gender:M
Credentials:CRNA
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Mailing Address - Street 1:100 MALLARD CREEK RD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4194
Mailing Address - Country:US
Mailing Address - Phone:502-690-8782
Mailing Address - Fax:502-459-0923
Practice Address - Street 1:100 MALLARD CREEK RD
Practice Address - Street 2:SUITE 320
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4194
Practice Address - Country:US
Practice Address - Phone:502-690-8782
Practice Address - Fax:502-459-0923
Is Sole Proprietor?:No
Enumeration Date:2013-12-12
Last Update Date:2014-01-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN28176219A163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse