Individual
MRS. KACIE LAUREN BLACKWELL BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
213 E MAIN ST, ROGUE RIVER, OR 97537-9100
(541) 714-5610
(541) 714-5611
Mailing address
213 E MAIN ST, ROGUE RIVER, OR 97537-9100
(541) 714-5610
(541) 714-5611
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10030427
OR
Other
Enumeration date
12/09/2019
Last updated
01/17/2025
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