Individual
MIGUEL PEREZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
12881 S WIDMER ST, OLATHE, KS 66062
(913) 424-7379
Mailing address
12881 S WIDMER ST, OLATHE, KS 66062
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2013010838
MO
363L00000X
Nurse Practitioner
53-75791-062
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2013010838
LICENSE
MO
01
—
53-75791-062
LICENSE
KS
Enumeration date
04/18/2014
Last updated
10/28/2015
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