Provider Demographics
NPI:1043545528
Name:PERKINS, CHARLENE MARIE (RN,LCCE,CD(DONA))
Entity type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:MARIE
Last Name:PERKINS
Suffix:
Gender:F
Credentials:RN,LCCE,CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 W 60TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-2806
Mailing Address - Country:US
Mailing Address - Phone:563-340-2241
Mailing Address - Fax:
Practice Address - Street 1:1011 W 60TH ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-2806
Practice Address - Country:US
Practice Address - Phone:563-340-2241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-16
Last Update Date:2009-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA5926374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula