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General NPI Number Information
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NPI Number | 1831075076
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Entity Type | Organization
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Legal Business Name | BERRY PEDIATRICS PLLC
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 112 S KENDRICK AVE
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City | GLENDIVE
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State | MT
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Zip | 59330-1627
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Country | US
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Telephone | 406-344-8278
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Fax | 406-831-5449
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Provider Business Mailing Address
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Address Line | 112 S KENDRICK AVE
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City | GLENDIVE
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State | MT
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Zip | 59330-1627
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Country | US
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Telephone | 406-344-8278
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Fax | 406-831-5449
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Authorized Official
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Title or Position | OWNER / PED. NURSE PRACTITIONER
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Name | DR. ERICCA BERRY
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Credential | DNP, CPNP
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Telephone | 406-344-8278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number |
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License Number State | NULL
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