Provider Demographics
NPI:1114723491
Name:PEREZ LUIS, LIBNI SIMEI (FNP-C)
Entity type:Individual
Prefix:
First Name:LIBNI
Middle Name:SIMEI
Last Name:PEREZ LUIS
Suffix:
Gender:
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 ALAMEDA BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-8807
Mailing Address - Country:US
Mailing Address - Phone:505-585-0085
Mailing Address - Fax:
Practice Address - Street 1:1648 ALAMEDA BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-8807
Practice Address - Country:US
Practice Address - Phone:505-585-0085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-19
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM58204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily