Provider Demographics
NPI:1942980495
Name:BERRY, SHERONDA (RN)
Entity Type:Individual
Prefix:
First Name:SHERONDA
Middle Name:
Last Name:BERRY
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 1:665 S PEAR ORCHARD RD STE 106-1179
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-4861
Mailing Address - Country:US
Mailing Address - Phone:601-660-3821
Mailing Address - Fax:
Practice Address - Street 1:1029 AIKERSON RD
Practice Address - Street 2:
Practice Address - City:LORMAN
Practice Address - State:MS
Practice Address - Zip Code:39096-5344
Practice Address - Country:US
Practice Address - Phone:601-529-9575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care