Provider Demographics
NPI:1639953854
Name:PEREZ, HEATHER ANN (FNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:PEREZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5817 PATTON ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-2428
Mailing Address - Country:US
Mailing Address - Phone:361-992-9383
Mailing Address - Fax:361-992-9543
Practice Address - Street 1:5817 PATTON ST STE 101
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-2428
Practice Address - Country:US
Practice Address - Phone:361-992-9383
Practice Address - Fax:361-992-9543
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily