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NPI Code Detail

MEDICARE: LUIS ENRIQUE PEREZ RN-C

MEDICARE: LUIS ENRIQUE PEREZ RN-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse Practitioner696585TX

General Provider Information

NPI Number : 1730143827
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS ENRIQUE PEREZ RN-C
Provider Business Mailing Address
First Line : 12419 WETTERHORN PEAK DR
Second Line :
City : PEYTON
State : CO
Zip : 80831-4407
Country : US
Telephone Number : 719-494-2215
Fax Number :
Provider Business Practice Location Address
First Line : 9320 GRAND CORDERA PKWY
Second Line : STE 100
City : COLORADO SPRINGS
State : CO
Zip : 80924-7004
Country : US
Telephone Number : 719-282-6337
Fax Number : 719-282-0532
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 01/23/2018

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Directions to “ LUIS ENRIQUE PEREZ RN-C” Practice Location

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