Provider Demographics
NPI:1912595380
Name:BERRIOS, VAKESIA (RN)
Entity Type:Individual
Prefix:
First Name:VAKESIA
Middle Name:
Last Name:BERRIOS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 RICE HOPE CT
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28056-6985
Mailing Address - Country:US
Mailing Address - Phone:980-395-5039
Mailing Address - Fax:
Practice Address - Street 1:1509 RICE HOPE CT
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28056-6985
Practice Address - Country:US
Practice Address - Phone:980-395-5039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-01
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC290385247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other