Individual
MARISA PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN, FNP
Contact information
Practice address
4321 FIR ST, EAST CHICAGO, IN 46312-3049
(219) 392-7200
Mailing address
5574 WASHINGTON ST, MERRILLVILLE, IN 46410-2058
(219) 980-0378
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28074874A
IN
363L00000X
Nurse Practitioner
71002794A
IN
363LF0000X
Family Nurse Practitioner
Primary
71002794A
IN
Other
Enumeration date
10/21/2008
Last updated
07/14/2020
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