Provider Demographics
NPI:1497570501
Name:PERRY, LUCRETIA NICOLE (RN)
Entity type:Individual
Prefix:
First Name:LUCRETIA
Middle Name:NICOLE
Last Name:PERRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LUCRETIA
Other - Middle Name:NICOLE
Other - Last Name:QUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9709 KEY WEST AVE APT 205
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-4501
Mailing Address - Country:US
Mailing Address - Phone:410-999-7652
Mailing Address - Fax:
Practice Address - Street 1:1949 4TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-1211
Practice Address - Country:US
Practice Address - Phone:301-458-0016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-22
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1054938163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health