Individual
KYAN ERIN BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1631 S ATHERTON ST STE 201, STATE COLLEGE, PA 16801-6229
(814) 235-9583
Mailing address
106 WALNUT AVE, ALTOONA, PA 16601-4938
(814) 201-0317
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN318249
PA
Other
Enumeration date
06/26/2023
Last updated
06/26/2023
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