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Individual
MRS. ERIN CALDWELL BERRY
Active
Individual
MRS. ERIN CALDWELL BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0110002107
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730167131
MEDICAID QMB
VA
01
—
371194700
BLACK LUNG
VA
01
—
540506332199
TRICARE/CHAMPUS
VA
01
—
P00822162
RAILROAD MEDICARE
VA
Enumeration date
01/05/2006
Last updated
08/18/2021
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