Doctor Name: | CAROLYN PERROTTI |
NPI Number: | 1639501877 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN |
License Number: | 12.005412 |
Business Practice Address: | 15301 Warren Shingle Rd Beale Afb, CA - 959031907 |
Business Phone Number: | 5306344662 |
Business Fax Number: | |
Mailing Address: | 15301 Warren Shingle Rd, BEALE AFB |
State: | CA |
Postal Code: | 959031907 |
Phone Number: | 5306344662 |
Fax Number: | |
NPI Enumeration Date: | 07/30/2013 |
NPI Last Update Date: | 11/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 12.005412 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |