Provider Demographics
NPI:1861930893
Name:PERRY, EMILIE
Entity type:Individual
Prefix:
First Name:EMILIE
Middle Name:
Last Name:PERRY
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 1:5242 ROSETRACE TER
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-8438
Mailing Address - Country:US
Mailing Address - Phone:404-951-8169
Mailing Address - Fax:
Practice Address - Street 1:5242 ROSETRACE TER
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-8438
Practice Address - Country:US
Practice Address - Phone:404-951-8169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-10
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN241524163W00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No251E00000XAgenciesHome Health