Individual
KEVIN BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
499 AZALEA DR, OXFORD, MS 38655
(662) 234-7979
(334) 244-1830
Mailing address
PO BOX 3488, DEPT 05-003, TUPELO, MS 38803-3488
(662) 234-7979
(334) 244-1830
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
23133
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
R798682
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06537247
—
MS
Enumeration date
01/17/2006
Last updated
05/23/2018
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