| NPI | 1568813517 |
|---|---|
| Former Name | AMANDA BURNS BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 21564) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MS 901607) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MS 901607) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MS 901607) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MS 901607) | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2022-11-30 |