Provider Demographics
NPI:1033099957
Name:PERKINS, TIFFANY VICTORIA (LPN)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:VICTORIA
Last Name:PERKINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5620 SPINDRIFT LN
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46220-5448
Mailing Address - Country:US
Mailing Address - Phone:317-989-3158
Mailing Address - Fax:
Practice Address - Street 1:5301 ROXBURY RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46226-1547
Practice Address - Country:US
Practice Address - Phone:317-226-4106
Practice Address - Fax:317-226-4551
Is Sole Proprietor?:No
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27070241A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse