Provider Demographics
NPI:1376251660
Name:PERO, MARIA (LPN)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:PERO
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2437 W PEGGY DR
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6684
Mailing Address - Country:US
Mailing Address - Phone:276-206-9395
Mailing Address - Fax:602-774-4537
Practice Address - Street 1:522 N CENTRAL AVE STE 831
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-2185
Practice Address - Country:US
Practice Address - Phone:276-206-9395
Practice Address - Fax:602-774-4537
Is Sole Proprietor?:No
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002097777164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse