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Individual

BILLIE BERARDI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
STNA

Contact information

Practice address
1744 DUMONT DRIVE, MINERAL RIDGE, OH 44440
(330) 951-4112
Mailing address
1744 DUMONT DRIVE, MINERAL RIDGE, OH 44440
(330) 951-4112

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400666690907
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0118229
OH
01
CS1511300311
CARESOURCE
OH
Enumeration date
06/15/2015
Last updated
06/15/2015
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