Provider Demographics
NPI:1558127134
Name:PEREZ GORDILLO, NURIA (WHNP)
Entity Type:Individual
Prefix:MISS
First Name:NURIA
Middle Name:
Last Name:PEREZ GORDILLO
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511-6152
Mailing Address - Country:US
Mailing Address - Phone:608-208-4285
Mailing Address - Fax:
Practice Address - Street 1:321 VERNON AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511-6152
Practice Address - Country:US
Practice Address - Phone:608-208-4285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15065-33363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health