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Individual

MARIE A BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
705 S UNIVERSITY AVE, STE 510, BEAVER DAM, WI 53916-3081
(920) 887-3102
(920) 885-8788
Mailing address
705 S UNIVERSITY AVE, STE 510, BEAVER DAM, WI 53916-3081
(920) 887-3102
(920) 885-8788

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
67440-030
WI
363L00000X
Nurse Practitioner
Primary
8-033
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2006175
PHYSICIANS PLUS
WI
01
4288
DEAN HEALTH INSURANCE
WI
05
43823400
WI
Enumeration date
05/12/2006
Last updated
05/02/2008
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