Provider Demographics
NPI:1255223129
Name:PERKINS, KYMEERA
Entity type:Individual
Prefix:
First Name:KYMEERA
Middle Name:
Last Name:PERKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16716 MILL STATION WAY
Mailing Address - Street 2:
Mailing Address - City:DUMFRIES
Mailing Address - State:VA
Mailing Address - Zip Code:22025-2202
Mailing Address - Country:US
Mailing Address - Phone:571-439-1358
Mailing Address - Fax:571-439-1358
Practice Address - Street 1:8427 DORSEY CIR STE 101
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4596
Practice Address - Country:US
Practice Address - Phone:855-464-1253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002106129164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse