Provider Demographics
NPI:1902046501
Name:PERO, DENISE JOANNE (NP)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:JOANNE
Last Name:PERO
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 EDGEWATER CIR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-3785
Mailing Address - Country:US
Mailing Address - Phone:805-390-0550
Mailing Address - Fax:
Practice Address - Street 1:271 EDGEWATER CIR
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-3785
Practice Address - Country:US
Practice Address - Phone:805-390-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-23
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA532854363L00000X
PASP015984363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner