Provider Demographics
NPI:1477097079
Name:PEREZ, JOEBELLE FIEL (LPN)
Entity type:Individual
Prefix:
First Name:JOEBELLE
Middle Name:FIEL
Last Name:PEREZ
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 1:9722 57TH AVE APT 14L
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3572
Mailing Address - Country:US
Mailing Address - Phone:347-891-6697
Mailing Address - Fax:
Practice Address - Street 1:9722 57TH AVE APT 14L
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3572
Practice Address - Country:US
Practice Address - Phone:347-891-6697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322423164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse