Organization
N/A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY GAYLE BERRY (RN)
(812) 697-1016
Entity
Organization
Contact information
Practice address
3108 ISLAND CT, JEFFERSONVILLE, IN 47130-8058
(812) 697-1016
Mailing address
3108 ISLAND CT, JEFFERSONVILLE, IN 47130-8058
(812) 697-1016
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1106110
KY
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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