Individual
WAKIYA CHANEL BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP-C
Contact information
Practice address
1875 REMOUNT RD, GASTONIA, NC 28054-7413
(704) 874-0600
Mailing address
200 E 2ND AVE, GASTONIA, NC 28052-4358
(704) 874-1900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
27183
SC
363LG0600X
Gerontology Nurse Practitioner
Primary
5008660
NC
Other
Enumeration date
06/23/2016
Last updated
02/03/2026
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