Provider Demographics
NPI:1659186807
Name:BERRY, KRISTIN L
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:L
Last Name:BERRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31871 MULBERRY DR
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:MO
Mailing Address - Zip Code:65355-4711
Mailing Address - Country:US
Mailing Address - Phone:816-260-6877
Mailing Address - Fax:
Practice Address - Street 1:210 E GLENMORE DR APT 203
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028-7944
Practice Address - Country:US
Practice Address - Phone:816-260-6877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care