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Individual

ELTON BERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
R.N., C.R.N.A.

Contact information

Practice address
4415 AICHOLTZ ROAD, MERCY HEALTH - EASTGATE MEDICAL CENTER, CINCINNATI, OH 45245
(513) 947-1130
(513) 947-8541
Mailing address
200 NORTHLAND BOULEVARD, OUTPATIENT ANESTHESIA SPECIALISTS, CINCINNATI, OH 45246
(513) 204-5696
(877) 284-4283

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
110791
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0968636
OH
Enumeration date
10/24/2005
Last updated
12/10/2013
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