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NPI Code Detail

MEDICARE: MS. PRISCELLA PEREZ PRIVATE DUTY NURSE

MEDICARE:  MS. PRISCELLA  PEREZ  PRIVATE DUTY NURSE
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
1164X00000XLicensed Vocational Nurse326375TX

General Provider Information

NPI Number : 1689157109
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PRISCELLA PEREZ PRIVATE DUTY NURSE
Provider Business Mailing Address
First Line : 11718 RADCLIFF CT
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-5947
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11718 RADCLIFF CT
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78253-5947
Country : US
Telephone Number : 567-315-9399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2018
Last Update Date : 09/11/2018

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Directions to “ MS. PRISCELLA PEREZ PRIVATE DUTY NURSE” Practice Location

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