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General NPI Number Information
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NPI Number | 1588408959
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Entity Type | Individual
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Provider Name | ELIZABETH ANNE BERRY PA
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Gender | Female
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Dates
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Enumeration Date | 06/20/2024
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Last Update Date | 06/20/2024
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Provider Practice Location Address
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Address Line | 2828 HIGHWAY 31 S STE 111
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City | DECATUR
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State | AL
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Zip | 35603-1538
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Country | US
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Telephone | 256-686-3456
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Fax | 256-686-3519
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Provider Business Mailing Address
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Address Line | 9626 WALDROP DR SE
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City | HUNTSVILLE
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State | AL
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Zip | 35803-2629
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Country | US
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Telephone | 256-508-2978
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2423
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License Number State | AL
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