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General NPI Number Information
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NPI Number | 1083238232
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Entity Type | Individual
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Provider Name | MANDY LYNN PERRY MSN, RN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 720 US HIGHWAY 259 N
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City | ORE CITY
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State | TX
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Zip | 75683-5763
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Country | US
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Telephone | 903-968-2847
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Fax | 903-968-2216
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Provider Business Mailing Address
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Address Line | 720 US HIGHWAY 259 N
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City | ORE CITY
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State | TX
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Zip | 75683-5763
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Country | US
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Telephone | 903-968-2847
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Fax | 903-968-8958
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1003536
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1003536
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 721246
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 163WI0500X
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Taxonomy Name | Infusion Therapy Registered Nurse
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License Number | 1003536
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License Number State | TX
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