Provider Demographics
NPI:1679185441
Name:PEREZ, MARGARITA (MSN, APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:MSN, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1680 COOPER FOSTER PARK RD W
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-3657
Mailing Address - Country:US
Mailing Address - Phone:440-444-0030
Mailing Address - Fax:440-444-0113
Practice Address - Street 1:1680 COOPER FOSTER PARK RD W
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-3657
Practice Address - Country:US
Practice Address - Phone:440-444-0030
Practice Address - Fax:440-444-0113
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH414658163WH0200X, 163WP0808X
OH0033441363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health