Provider Demographics
NPI:1316413297
Name:BERRY, JADRIEN MARLETTE (FNP)
Entity Type:Individual
Prefix:
First Name:JADRIEN
Middle Name:MARLETTE
Last Name:BERRY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JADRIEN
Other - Middle Name:BERRY
Other - Last Name:PRATHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1860
Mailing Address - Fax:
Practice Address - Street 1:225 SE JOHN JONES DR
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-8341
Practice Address - Country:US
Practice Address - Phone:817-447-0445
Practice Address - Fax:817-447-2273
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily