Provider Demographics
NPI:1831163617
Name:PERKUCHIN, DEEANN M (BSN, RN, MSN, ANP)
Entity type:Individual
Prefix:MISS
First Name:DEEANN
Middle Name:M
Last Name:PERKUCHIN
Suffix:
Gender:F
Credentials:BSN, RN, MSN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6611 HIGH VALLEY LANE
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315
Mailing Address - Country:US
Mailing Address - Phone:703-372-2771
Mailing Address - Fax:
Practice Address - Street 1:EISENHOWER EXECUTIVE OFFICE BUILDING ROOM 53
Practice Address - Street 2:PENNSYLVANIA AVENUE
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20500
Practice Address - Country:US
Practice Address - Phone:202-757-2476
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165897363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health