Provider Demographics
NPI:1356062921
Name:BERRY, JENNIFER A (APRN-CNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:BERRY
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 BRAZOS DR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77523-1528
Mailing Address - Country:US
Mailing Address - Phone:207-431-4181
Mailing Address - Fax:
Practice Address - Street 1:202 BRAZOS DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77523-1528
Practice Address - Country:US
Practice Address - Phone:207-431-4181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1091858363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care