Individual
TABATHA JO BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
420 THROCKMORTON RD, MADISON, NC 27025-7940
(336) 427-5849
Mailing address
420 THROCKMORTON RD, MADISON, NC 27025-7940
(336) 427-5849
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
085590
NC
Other
Enumeration date
09/29/2010
Last updated
09/29/2010
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