Provider Demographics
NPI:1053183376
Name:PERRY, KAMI ALYSS (CRNP)
Entity type:Individual
Prefix:MRS
First Name:KAMI
Middle Name:ALYSS
Last Name:PERRY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11664 CHIGGER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35444-0719
Mailing Address - Country:US
Mailing Address - Phone:205-470-1110
Mailing Address - Fax:
Practice Address - Street 1:216 AQUARIUS DR STE 306
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-5863
Practice Address - Country:US
Practice Address - Phone:205-949-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-139707363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily