Individual
MR. RONALD ARTHUR BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, FNP
Contact information
Practice address
1270 KOTNUM ROAD, WARM SPRINGS, OR 97761-1209
(541) 553-1196
(541) 553-2457
Mailing address
PO BOX 1209, WARM SPRINGS, OR 97761-1209
(541) 553-1196
(541) 553-2457
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
17377.148
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273855
—
OR
01
—
8HD971
PERSONAL MEDICARE ID
NM
01
—
HSZ204
MEDICARE FEDERAL HEALTH CARE FACILITY
OR
Enumeration date
11/02/2005
Last updated
03/31/2010
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