Individual
KENNETH A PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
126 US HIGHWAY 280 W, AMERICUS, GA 31719-8645
(229) 924-6011
Mailing address
2002 PALMYRA RD STE 201, ALBANY, GA 31701-1593
(229) 312-5863
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN226042
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
226042
RN LICENSE
GA
Enumeration date
11/01/2021
Last updated
11/01/2021
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