Provider Demographics
NPI:1639486731
Name:BERILL, NANCY J (CRNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:J
Last Name:BERILL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-5736
Mailing Address - Fax:717-851-6162
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-5736
Practice Address - Fax:717-851-2479
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010965363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1592663OtherGATEWAY-WMG
PA2572892OtherHIGHMARK BLUE SHIELD-WMG
PA194163FLTMedicare PIN
PA194163FLTMedicare PIN