Provider Demographics
NPI:1083394696
Name:BERRY, EMILY ROBINSON (BS)
Entity Type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:ROBINSON
Last Name:BERRY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 GREENGATE CIR APT D
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-7438
Mailing Address - Country:US
Mailing Address - Phone:803-920-0967
Mailing Address - Fax:
Practice Address - Street 1:1135 GREGG HWY NW
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6341
Practice Address - Country:US
Practice Address - Phone:803-641-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program