| Doctor Name: | KRISTY PERRY |
| NPI Number: | 1902220114 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 657357 |
| Business Practice Address: | 805 N. Dickinson Dr. Rusk, TX - 75785 |
| Business Phone Number: | 9036833421 |
| Business Fax Number: | |
| Mailing Address: | 805 N. Dickinson St., RUSK |
| State: | TX |
| Postal Code: | 75785 |
| Phone Number: | 9036833421 |
| Fax Number: | |
| NPI Enumeration Date: | 02/07/2014 |
| NPI Last Update Date: | 02/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 657357 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |