Individual
DR. TANA FRIESTH PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
201 RIDGE ST STE 312, COUNCIL BLUFFS, IA 51503-4643
(712) 396-7885
(712) 396-7885
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
94-08716
KS
207V00000X
Obstetrics & Gynecology Physician
Primary
MD-46134
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10026211300
—
NE
05
—
1942696901
—
IA
05
—
47068731777
—
NE
Enumeration date
04/07/2015
Last updated
08/20/2019
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