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NPI Code Detail

MEDICARE: DR. CORRIE TYNE BERK DNP

MEDICARE:  DR. CORRIE TYNE BERK  DNP
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
1363LF0000XFamily Nurse PractitionerAPRN002798NV
2363L00000XNurse Practitioner1111600TX

General Provider Information

NPI Number : 1497299184
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CORRIE TYNE BERK DNP
Provider Business Mailing Address
First Line : 3066 E COMMERCE ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78220-1013
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4751 HAMILTON WOLFE RD STE 200
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78229-3458
Country : US
Telephone Number : 210-233-7126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2016
Last Update Date : 07/10/2023

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Directions to “ DR. CORRIE TYNE BERK DNP” Practice Location

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