Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Annie Larissa Perdomo, ARNP

Individual provider Acute Care Nurse Practitioner · NPI 1891413498

Annie Larissa Perdomo, ARNP is a Nurse Practitioner in Glendale, Arizona. Qualified in 2022, 4 years ago. Practices with Privia Medical Group Arizona, LLC, a 96-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
4
Licensed in
AZ
In the registry since
2022
What do these letters mean?
ARNP — Advanced Registered Nurse Practitioner
The title some states use for an advanced practice nurse.

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Practice location Address checks out

7330 N 99th Ave Ste 325
Glendale, AZ 85307-3022
Phone: (480) 398-7620
Fax: (480) 398-7621
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 279414 (AZ)

Record details

NPI number1891413498
Entity typeIndividual (Type 1)
GenderFemale
Credentials ARNP
Sole proprietorNo
NPI enumeratedAugust 19, 2022
Last updated in NPPESJuly 30, 2024
Certification dateJuly 30, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Privia Medical Group Arizona, Llc — 96 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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