Provider Demographics
NPI:1073752028
Name:BERRY, JARMECA NORRIS (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JARMECA
Middle Name:NORRIS
Last Name:BERRY
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7777 HENNESSY BLVD
Mailing Address - Street 2:SUITE1008
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-766-0416
Mailing Address - Fax:225-769-9212
Practice Address - Street 1:7777 HENNESSY BLVD
Practice Address - Street 2:SUITE 1008
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-4300
Practice Address - Country:US
Practice Address - Phone:225-766-0416
Practice Address - Fax:225-769-9212
Is Sole Proprietor?:No
Enumeration Date:2009-02-16
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05598363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1381101Medicaid