Individual
MR. DIEGO PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1515 RIVER PL STE 100, BRASELTON, GA 30517
(770) 848-6195
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN253260
GA
363LF0000X
Family Nurse Practitioner
Primary
RN253260
GA
Other
Enumeration date
08/01/2019
Last updated
08/08/2019
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