Individual
PENNY LEIGH PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-4001
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
23992
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/02/2020
Last updated
10/23/2020
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