Provider Demographics
NPI:1316698806
Name:PEREZ, MERCEDES (CNP)
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:PEREZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6855 BRETTIN DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-6542
Mailing Address - Country:US
Mailing Address - Phone:216-773-3282
Mailing Address - Fax:
Practice Address - Street 1:6855 BRETTIN DR
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-6542
Practice Address - Country:US
Practice Address - Phone:216-773-3282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-16
Last Update Date:2022-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0030605363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily