Keith Perry

Individual provider Active NPI Licensed Practical Nurse · Bridgeville, DE

NPI 1487045878 · NPPES record last updated Feb 7, 2015

Key facts

NPI
1487045878
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
L2-0012353 (DE)
Practice address
16515 Cedar Corners Rd
Bridgeville, DE 19933-4148
Phone
(302) 841-1514
NPI assigned
Feb 7, 2015
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
L2-0012353DEMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L2-0012353 DE Yes

Addresses

Primary practice location

16515 Cedar Corners Rd
Bridgeville, DE 19933-4148

Mailing address

16515 Cedar Corners Rd
Bridgeville, DE 19933-4148
Phone (302) 841-1514

Other providers in Bridgeville, DE

All providers in Bridgeville, DE · Licensed Practical Nurse in Delaware

Sources for this page

Verify at the official NPI Registry.