Provider Demographics
NPI:1770533671
Name:PEREZ, MARGARET ELAINE (APRN, BC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:ELAINE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:M
Other - Middle Name:ELAINE
Other - Last Name:PEREZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN, BC
Mailing Address - Street 1:1331 N. 7TH ST.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2779
Mailing Address - Country:US
Mailing Address - Phone:602-277-6181
Mailing Address - Fax:602-253-6059
Practice Address - Street 1:1331 N. 7TH ST
Practice Address - Street 2:400
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2779
Practice Address - Country:US
Practice Address - Phone:602-277-6181
Practice Address - Fax:602-253-6059
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP1377363LA2100X
AZRN042325163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ840167Medicaid
AZ75527Medicare PIN
AZ840167Medicaid
AZ75526Medicare PIN