Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 779129 | TX |
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP4163 | AZ |
NPI | 1023349735 |
---|---|
Provider Name | Carina Chan Perez |
First Address | Phoenix, AZ 85018-2327 |
Second Address | Phoenix, AZ 85016-7710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2010 |
Last Update Date | 30/01/2018 |