Individual
MRS. JACKIE W BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
886 HIGHWAY 411 N, ETOWAH, TN 37331-1912
(423) 263-3600
Mailing address
886 HIGHWAY 411 N, ETOWAH, TN 37331-1912
(423) 263-3600
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LDN0000001639
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
877298
REGISTERED DIETITIAN
TN
Enumeration date
12/17/2009
Last updated
12/17/2009
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