Provider Demographics
NPI:1467291781
Name:PEREZ-MARTINEZ, JESSICA (RN)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:PEREZ-MARTINEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9009 CAROTHERS PKWY STE C1
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1704
Mailing Address - Country:US
Mailing Address - Phone:615-538-7739
Mailing Address - Fax:
Practice Address - Street 1:GREEN BAY CTC
Practice Address - Street 2:2357 W. MASON ST.
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54303-4708
Practice Address - Country:US
Practice Address - Phone:920-337-6740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1088296163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse