Individual
MRS. MARY WAIT BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
11803 JEFFERSON AVE STE 235, NEWPORT NEWS, VA 23606-2565
(757) 594-1806
(757) 510-9079
Mailing address
11803 JEFFERSON AVE STE 235, NEWPORT NEWS, VA 23606-2565
(757) 594-1806
(757) 510-9079
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024164915
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500026470
RAILROAD MEDICARE
VA
05
—
7790660
—
VA
Enumeration date
12/29/2005
Last updated
06/07/2024
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