Provider Demographics
NPI:1629447859
Name:BERKLEY, CORTNEY RACHELLE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CORTNEY
Middle Name:RACHELLE
Last Name:BERKLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:CORTNEY
Other - Middle Name:RACHELLE
Other - Last Name:BERKLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP, PMHNP
Mailing Address - Street 1:PO BOX 2435
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:TX
Mailing Address - Zip Code:76430-8020
Mailing Address - Country:US
Mailing Address - Phone:254-559-7215
Mailing Address - Fax:
Practice Address - Street 1:2802 W WALKER ST
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE
Practice Address - State:TX
Practice Address - Zip Code:76424-4000
Practice Address - Country:US
Practice Address - Phone:254-559-7215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129054363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily