Healthcare Provider Details

I. General information

NPI: 1265395560
Provider Name (Legal Business Name): MEGAN BERRY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 6TH AVE STE 108
YORK PA
17403-2626
US

IV. Provider business mailing address

1600 6TH AVE STE 108
YORK PA
17403-2626
US

V. Phone/Fax

Practice location:
  • Phone: 717-356-4705
  • Fax:
Mailing address:
  • Phone: 717-356-4705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberRN537688
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: