Provider Demographics
NPI:1164864898
Name:PEREZ, ANNETTE JEANNE (CNM)
Entity Type:Individual
Prefix:
First Name:ANNETTE
Middle Name:JEANNE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4824 ALBERTA AVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2709
Mailing Address - Country:US
Mailing Address - Phone:915-544-1200
Mailing Address - Fax:915-521-7980
Practice Address - Street 1:4824 ALBERTA AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2709
Practice Address - Country:US
Practice Address - Phone:915-544-1200
Practice Address - Fax:915-521-7980
Is Sole Proprietor?:No
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX569599176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife