Provider Demographics
NPI:1669512992
Name:IRELANDBERK, SHERI LYNN (PT)
Entity type:Individual
Prefix:MRS
First Name:SHERI
Middle Name:LYNN
Last Name:IRELANDBERK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1013 BRACKEN FERN DR
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-7150
Mailing Address - Country:US
Mailing Address - Phone:252-497-8350
Mailing Address - Fax:
Practice Address - Street 1:2111 NEUSE BLVD STE D
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28560-4318
Practice Address - Country:US
Practice Address - Phone:252-497-8350
Practice Address - Fax:252-999-6905
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14814225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09932114OtherBCBS