Individual provider · NPI-1

Juana Berry

Contractor · Dallas, TX

NPI number1639727522
StatusActive
Last updated in NPPESMay 4, 2020

Details

NPI
1639727522
Entity type
Individual (NPI-1)
Name
Juana Berry
Sex
Female
Sole proprietor
No
Enumeration date
Sep 3, 2019
Certification date
May 4, 2020
Last updated
May 4, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
171W00000X Contractor––Yes
163W00000X Registered Nurse882040TX

Practice location

2042 Wild Creek Ct
Dallas, TX 75253-5472

Phone 972-342-8527 · Fax 972-286-8330

Mailing address

2042 Wild Creek Ct
Dallas, TX 75253-5472

Other practice locations

6726 Sunshade Ln
Dallas, TX 75236-0103

Phone 972-342-8527

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