Healthcare Provider Details

I. General information

NPI: 1528976073
Provider Name (Legal Business Name): MRS. ANITA JOY PEREZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 W WASHINGTON ST
VENANGO NE
69168-1048
US

IV. Provider business mailing address

302 W WASHINGTON ST
VENANGO NE
69168-1048
US

V. Phone/Fax

Practice location:
  • Phone: 308-520-3901
  • Fax:
Mailing address:
  • Phone: 308-520-3901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberH12468820
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: