| NPI | 1821730649 |
|---|---|
| Former Name | CASEY MIRANDA BERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: SC 25903) |
| Enumeration Date | 2022-04-12 |
| Last Update Date | 2024-01-24 |