Provider Demographics
NPI:1871929216
Name:PERRY, ERICA DENISE
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:DENISE
Last Name:PERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7215 JALISCO RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4564
Mailing Address - Country:US
Mailing Address - Phone:575-495-5975
Mailing Address - Fax:
Practice Address - Street 1:7215 JALISCO RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4564
Practice Address - Country:US
Practice Address - Phone:575-495-5975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion