Provider Demographics
NPI:1104531409
Name:PEREZ, AMBER MARIE (FNP-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:PEREZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:DOVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:226 KNAPP ST
Mailing Address - Street 2:
Mailing Address - City:ALLEGAN
Mailing Address - State:MI
Mailing Address - Zip Code:49010-1518
Mailing Address - Country:US
Mailing Address - Phone:660-631-2867
Mailing Address - Fax:
Practice Address - Street 1:226 KNAPP ST
Practice Address - Street 2:
Practice Address - City:ALLEGAN
Practice Address - State:MI
Practice Address - Zip Code:49010-1518
Practice Address - Country:US
Practice Address - Phone:660-631-2867
Practice Address - Fax:269-355-1874
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704317942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily