Blaire Alexandria Berry-Young, LPN
In Home Supportive Care in Jackson, TN. Individual provider (NPI-1).
NPI number1417696477
StatusActive
Last updated in NPPESMay 28, 2022
Details
- NPI
- 1417696477
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Blaire Alexandria Berry-Young
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 28, 2022
- Certification date
- May 13, 2022
- Last updated
- May 28, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
| 174200000X | Meals | – | – | |
| 251V00000X | Voluntary or Charitable | – | – | |
| 172A00000X | Driver | – | – | |
| 332U00000X | Home Delivered Meals | – | – | |
| 343900000X | Non-emergency Medical Transport (VAN) | – | – | |
| 347C00000X | Private Vehicle | – | – | |
| 372500000X | Chore Provider | – | – | |
| 372600000X | Adult Companion | – | – | |
| 374700000X | Technician | – | – | |
| 3747A0650X | Technician, Attendant Care Provider | – | – | |
| 3747P1801X | Technician, Personal Care Attendant | – | – | |
| 376K00000X | Nurse's Aide | – | – | |
| 385H00000X | Respite Care | – | – |
Practice location
38 Chippewa CirJackson, TN 38305-1619
Phone 731-277-6924
Mailing address
Po Box 10662Jackson, TN 38308-0111
Phone 731-277-6924
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