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General NPI Number Information
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NPI Number | 1245152792
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Entity Type | Individual
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Provider Name | JANAISHA BERRY NP
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Gender | Female
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 1107 GRAND AVE
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City | LENA
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State | MS
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Zip | 39094-8994
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Country | US
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Telephone | 601-382-5724
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Fax |
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Provider Business Mailing Address
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Address Line | 207 ZION HILL RD
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City | MENDENHALL
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State | MS
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Zip | 39114-5906
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Country | US
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Telephone | 601-382-5724
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Fax |
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 908630
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License Number State | MS
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