Provider Demographics
NPI:1679820252
Name:BERKERY, SHIRLEY (RN)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:
Last Name:BERKERY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NORMANDY RD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:MADEIRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33708-2325
Mailing Address - Country:US
Mailing Address - Phone:813-541-3234
Mailing Address - Fax:
Practice Address - Street 1:500 NORMANDY RD
Practice Address - Street 2:UNIT 2
Practice Address - City:MADEIRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33708-2325
Practice Address - Country:US
Practice Address - Phone:813-541-3234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-13
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1737332163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse