Provider Demographics
NPI:1669046744
Name:PERRY, PARESHIA LAIRE
Entity type:Individual
Prefix:MS
First Name:PARESHIA
Middle Name:LAIRE
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6328 N 38TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-1120
Mailing Address - Country:US
Mailing Address - Phone:402-415-5894
Mailing Address - Fax:
Practice Address - Street 1:6328 N 38TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-1120
Practice Address - Country:US
Practice Address - Phone:402-415-5894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health