Lateasha Berry, FNP-C
Nurse Practitioner, Family in Rincon, GA. Individual provider (NPI-1).
NPI number1205669348
StatusActive
Last updated in NPPESAug 23, 2024
Details
- NPI
- 1205669348
- Entity type
- Individual (NPI-1)
- Name
- Lateasha Berry
- Credential
- FNP-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 23, 2024
- Certification date
- Aug 23, 2024
- Last updated
- Aug 23, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 225945 | GA | Yes |
Practice location
Po Box 1766Rincon, GA 31326-1766
Phone 912-663-4539
Mailing address
Po Box 1766Rincon, GA 31326-1766
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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