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Individual
MRS. JENNY REPLOGLE BERRY
Active
Individual
MRS. JENNY REPLOGLE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1953
TX
363LA2200X
Adult Health Nurse Practitioner
2012004406
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308238001
—
TX
01
—
880N26
BCBS
TX
Enumeration date
07/03/2012
Last updated
01/17/2013
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