Individual
MS. LILLIAN M BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
444 W OSBORN RD, SUITE 200, PHOENIX, AZ 85013-3814
(602) 230-1400
(602) 230-7676
Mailing address
PO BOX 29870, PHOENIX, AZ 85038-9870
(602) 772-3805
(602) 772-3801
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1959
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3Z3956
HEALTHNET
AZ
05
—
454025
—
AZ
Enumeration date
01/23/2006
Last updated
03/14/2014
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