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Individual

MARTHA G BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
2508 CRESTWOOD RD, NORTH LITTLE ROCK, AR 72116-7623
(501) 758-2298
(501) 758-7877
Mailing address
11001 EXECUTIVE CENTER DR, LITTLE ROCK, AR 72211-4316
(501) 758-2298
(501) 758-7877

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R33544
AR
363LF0000X
Family Nurse Practitioner
Primary
A01874
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
189490758
AR
01
492829ZNUD
MEDICARE
AR
Enumeration date
05/25/2006
Last updated
10/18/2022
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