Individual
HALLE BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4176 BEAMER DR, FORNEY, TX 75126-3020
(334) 450-9832
Mailing address
4176 BEAMER DR, FORNEY, TX 75126-3020
(334) 450-9832
Taxonomy
Speciality
Code
Description
License number
State
163WN0002X
Neonatal Intensive Care Registered Nurse
1-159664
AL
363LN0000X
Neonatal Nurse Practitioner
Primary
1141012
TX
Other
Enumeration date
10/04/2023
Last updated
03/07/2024
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