Individual
KELLY L PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
13920 QUAILBROOK DR, OKLAHOMA CITY, OK 73134-1718
(405) 848-8884
(405) 713-4656
Mailing address
5300 N INDEPENDENCE AVE STE 280, OKLAHOMA CITY, OK 73112-5555
(405) 848-8884
(405) 713-4656
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
105235
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A080154544
OKLAHOMA DRIVERS LICENSE
OK
Enumeration date
06/04/2019
Last updated
09/29/2021
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