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NPI Code Detail

MEDICARE: DARLA JO BERRY CNM

MEDICARE:   DARLA JO BERRY  CNM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367A00000XAdvanced Practice Midwife28113679AIN
2367A00000XAdvanced Practice Midwife0900066AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073594255
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARLA JO BERRY CNM
Provider Business Mailing Address
First Line : 6626 E 75TH ST STE 500
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2890
Country : US
Telephone Number : 317-621-7547
Fax Number :
Provider Business Practice Location Address
First Line : 7120 CLEARVISTA DR STE 5100
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1868
Country : US
Telephone Number : 317-621-7120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2005
Last Update Date : 04/18/2025

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Directions to “ DARLA JO BERRY CNM” Practice Location

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