Individual
TINISHIA NICOLE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1200 E JAMES LEE BLVD, CRESTVIEW, FL 32539-3126
(850) 689-5690
(850) 689-5696
Mailing address
2627 CORNER CREEK RD, CRESTVIEW, FL 32536-4381
(850) 797-3775
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5208967
FL
Other
Enumeration date
11/11/2021
Last updated
11/11/2021
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