Provider Demographics
NPI:1447384565
Name:BERRY, JULIANNE R (RPH)
Entity Type:Individual
Prefix:MS
First Name:JULIANNE
Middle Name:R
Last Name:BERRY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:JULIANNE
Other - Middle Name:R
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:2777 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-1239
Mailing Address - Country:US
Mailing Address - Phone:517-787-3467
Mailing Address - Fax:517-783-0065
Practice Address - Street 1:2777 AIRPORT RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-1239
Practice Address - Country:US
Practice Address - Phone:517-783-0033
Practice Address - Fax:517-783-0065
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2008-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028156183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist