Provider Demographics
NPI:1225911688
Name:PERKINS, LATRENNIA EVETTE
Entity type:Individual
Prefix:
First Name:LATRENNIA
Middle Name:EVETTE
Last Name:PERKINS
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 1:24024 EVERGREEN RD APT 108A
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5517
Mailing Address - Country:US
Mailing Address - Phone:313-721-5877
Mailing Address - Fax:
Practice Address - Street 1:24024 EVERGREEN RD APT 108A
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5517
Practice Address - Country:US
Practice Address - Phone:313-721-5877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker