Provider Demographics
NPI:1134460421
Name:BERRY, ERICA LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:LYNN
Last Name:BERRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 PIEDMONT CENTER PLZ
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-4036
Mailing Address - Country:US
Mailing Address - Phone:540-347-7611
Mailing Address - Fax:
Practice Address - Street 1:6950 PIEDMONT CENTER PLZ
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-4036
Practice Address - Country:US
Practice Address - Phone:540-347-7611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-11
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024170530363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily