| NPI | 1356696967 |
|---|---|
| Former Name | MICHELLE A. BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-75737) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 106893) |
| Enumeration Date | 2012-07-19 |
| Last Update Date | 2024-08-01 |