Individual
SUSAN DENISE PERRY-FORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
824 CUMBERLAND DR, SUNNYVALE, CA 94087-1221
(669) 267-4584
Mailing address
4785 BANNOCK CIR, SAN JOSE, CA 95130-2202
(408) 504-5543
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
95233142
CA
Other
Enumeration date
03/08/2024
Last updated
03/08/2024
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