Provider Demographics
NPI:1982478566
Name:PEREZ, BRIANA ARIELLE (LPN)
Entity Type:Individual
Prefix:
First Name:BRIANA
Middle Name:ARIELLE
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 1:6714 SALLY CT
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505-5419
Mailing Address - Country:US
Mailing Address - Phone:810-964-9327
Mailing Address - Fax:
Practice Address - Street 1:7462 N GENESEE RD
Practice Address - Street 2:
Practice Address - City:GENESEE
Practice Address - State:MI
Practice Address - Zip Code:48437-7723
Practice Address - Country:US
Practice Address - Phone:810-224-1079
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703115756164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse