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General NPI Number Information
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NPI Number | 1003354788
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Entity Type | Individual
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Provider Name | JANA MARIE BERRY FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 03/14/2025
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Provider Practice Location Address
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Address Line | 6459 HIGHWAY 72
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City | KILLEN
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State | AL
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Zip | 35645-8258
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Country | US
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Telephone | 256-272-0275
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 70
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City | KILLEN
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State | AL
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Zip | 35645-0070
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Country | US
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Telephone | 256-272-0275
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Fax | 256-272-0277
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-113271
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License Number State | AL
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