Provider Demographics
NPI:1003345729
Name:BERRY, LEYLA Q (MSN, RN, CNE, FNP-C)
Entity Type:Individual
Prefix:
First Name:LEYLA
Middle Name:Q
Last Name:BERRY
Suffix:
Gender:F
Credentials:MSN, RN, CNE, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1050
Mailing Address - Country:US
Mailing Address - Phone:734-764-8320
Mailing Address - Fax:734-647-3630
Practice Address - Street 1:207 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1050
Practice Address - Country:US
Practice Address - Phone:734-764-8320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704278404163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse