Doctor Name: | CARISSA PERINE |
NPI Number: | 1104260561 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN |
License Number: | 380929 |
Business Practice Address: | 6004 Campbell Rd Mentor On The Lake, OH - 440603024 |
Business Phone Number: | 4402310373 |
Business Fax Number: | |
Mailing Address: | 6004 Campbell Rd, MENTOR ON THE LAKE |
State: | OH |
Postal Code: | 440603024 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/29/2013 |
NPI Last Update Date: | 04/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC0200X |
License Number: | 380929 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Critical Care Medicine |
Taxonomy Definition: |