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Individual
MANDY LYNN PERRY
Active
Individual
MANDY LYNN PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, FNP-C
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
1003536
TX
363LF0000X
Family Nurse Practitioner
Primary
1003536
TX
363LF0000X
Family Nurse Practitioner
721246
TX
363LP2300X
Primary Care Nurse Practitioner
1003536
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083238232
SUPERIOR HEALTH PLAN
TX
01
—
1694561564
AMERIGROUP
TX
05
—
431976601
—
TX
01
—
9363417
CIGNA
TX
01
—
H000RJ8101
BLUECROSS BLUESHEILD
TX
Enumeration date
06/03/2020
Last updated
11/21/2022
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