Provider Demographics
NPI:1043005770
Name:BERRY, CHLOEE
Entity type:Individual
Prefix:
First Name:CHLOEE
Middle Name:
Last Name:BERRY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 MEDINA RD
Mailing Address - Street 2:
Mailing Address - City:SANDYVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25275-7567
Mailing Address - Country:US
Mailing Address - Phone:304-786-6717
Mailing Address - Fax:
Practice Address - Street 1:2406 26TH PL
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-7102
Practice Address - Country:US
Practice Address - Phone:304-531-2623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant