Provider Demographics
NPI:1568919330
Name:BERRY NP SERVICES
Entity Type:Organization
Organization Name:BERRY NP SERVICES
Other - Org Name:TRUE CARE FAMILY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/FNP
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:662-401-2793
Mailing Address - Street 1:803 MAYNARD DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-5651
Mailing Address - Country:US
Mailing Address - Phone:662-401-2793
Mailing Address - Fax:662-813-5137
Practice Address - Street 1:200 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-2712
Practice Address - Country:US
Practice Address - Phone:662-813-5135
Practice Address - Fax:662-813-5137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR872877363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty