Provider Demographics
NPI:1861543191
Name:PERFETTO, CAROL LYNN (CRNP)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:LYNN
Last Name:PERFETTO
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:8743 CARRIAGE HILLS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2604
Mailing Address - Country:US
Mailing Address - Phone:410-381-9455
Mailing Address - Fax:410-381-9455
Practice Address - Street 1:4940 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-2735
Practice Address - Country:US
Practice Address - Phone:410-550-7044
Practice Address - Fax:410-550-7414
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDR087790363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology