Provider Demographics
NPI:1134965437
Name:PERRY, KRISTI RUNION (RN, IBCLC)
Entity type:Individual
Prefix:
First Name:KRISTI
Middle Name:RUNION
Last Name:PERRY
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 SAMPLES CHAPEL RD SE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37323-8905
Mailing Address - Country:US
Mailing Address - Phone:423-241-0524
Mailing Address - Fax:
Practice Address - Street 1:875 SAMPLES CHAPEL RD SE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37323-8905
Practice Address - Country:US
Practice Address - Phone:423-241-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN100653163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn