Provider Demographics
NPI:1023443660
Name:PERRY, GRACE VICTORIA (RN MSN APN-C OCN)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:VICTORIA
Last Name:PERRY
Suffix:
Gender:F
Credentials:RN MSN APN-C OCN
Other - Prefix:
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Mailing Address - Street 1:31 GLENN CT
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-1114
Mailing Address - Country:US
Mailing Address - Phone:201-939-2761
Mailing Address - Fax:
Practice Address - Street 1:92 2ND ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2191
Practice Address - Country:US
Practice Address - Phone:551-996-5900
Practice Address - Fax:551-996-0574
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00436800363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner