Provider Demographics
NPI:1134806912
Name:BERRY, BRANDI JOI (MSW)
Entity type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:JOI
Last Name:BERRY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2033 BRIDGEPORT RD NE APT 133
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49505-6309
Mailing Address - Country:US
Mailing Address - Phone:616-426-1175
Mailing Address - Fax:
Practice Address - Street 1:2033 BRIDGEPORT RD NE APT 133
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49505-6309
Practice Address - Country:US
Practice Address - Phone:616-426-1175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty