Individual
REBECCA L BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
2205 E 70TH ST, SHREVEPORT, LA 71105-5321
(318) 797-1585
(318) 797-6077
Mailing address
2205 E. 70TH STREET, SHREVEPORT, LA 71105-3813
(318) 797-1585
(318) 797-6077
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP06053
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2129678
—
LA
Enumeration date
11/03/2010
Last updated
04/09/2019
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