Tricia Anne Perrine, RN

Individual provider Active NPI Registered Nurse · Sullivan, WI

NPI 1104407295 · NPPES record last updated Apr 20, 2021

Key facts

NPI
1104407295
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
312688 (WI)
Practice address
N4659 Indian Point Rd
Sullivan, WI 53178-9716
Phone
(414) 588-1142
NPI assigned
Apr 20, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
312688WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 312688 WI Yes

Addresses

Primary practice location

N4659 Indian Point Rd
Sullivan, WI 53178-9716

Mailing address

N4659 Indian Point Rd
Sullivan, WI 53178-9716
Phone (414) 588-1142

Other providers in Sullivan, WI

All providers in Sullivan, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.