Individual
LISA PEREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN RN AGPCNP-BC
Contact information
Practice address
2208 LIPSCOMB ST, FT WORTH, TX 76110-2049
(817) 921-3307
Mailing address
2208 LIPSCOMB ST, FT WORTH, TX 76110-2049
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
537708
TX
363LG0600X
Gerontology Nurse Practitioner
537708
TX
Other
Enumeration date
03/21/2014
Last updated
03/21/2014
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