MEDICARE: MRS. CHARLENE BERRY CASON

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
1	347C00000X	Private Vehicle	VMC7863	VA

General Provider Information

NPI Number	:	1669340527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHARLENE BERRY CASON

Provider Business Mailing Address
First Line	:	2037 CHICORY ST
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-5922
Country	:	US
Telephone Number	:	757-739-5904
Fax Number	:

Provider Business Practice Location Address
First Line	:	2037 CHICORY ST
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23453-5922
Country	:	US
Telephone Number	:	757-739-5904
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2025
Last Update Date	:	10/30/2025

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