Individual
MICHAEL R BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 345-2623
(507) 389-4685
Mailing address
PO BOX 517, 605 MILLER LANE, SAINT CLAIR, MN 56080-0517
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R139685-2
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133973
UCARE
—
01
—
2003612
MEDICA
—
01
—
436L0BE
BCBS OF MN
—
05
—
637498000
—
MN
01
—
967551047349
PREFERRED ONE
—
01
—
HP68767
HEALTH PARTNERS
—
Enumeration date
08/10/2006
Last updated
09/17/2020
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