Individual
GWEN LEA BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
212 2ND AVE S, LONG PRAIRIE, MN 56347-1608
(320) 732-4500
Mailing address
212 2ND AVE S, LONG PRAIRIE, MN 56347-1608
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
1402843
MN
Other
Enumeration date
01/15/2019
Last updated
01/15/2019
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