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Individual
MRS. VALERIE PERONA
Active
Individual
MRS. VALERIE PERONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.355172
IL
363LF0000X
Family Nurse Practitioner
Primary
209.014764
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
206147
MEDICARE GROUP PTAN
IL
01
—
F400331407
MEDICARE INDIVID PTAN
IL
Enumeration date
09/01/2016
Last updated
10/19/2016
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