Individual
MRS. JACKIE LOUISE BERRYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN/CNS
Contact information
Practice address
623 CIRCLE DR, WELLINGTON, KS 67152-3207
(620) 968-7076
Mailing address
701 SE STONE RD, EL DORADO, KS 67042-5500
(316) 320-7766
Taxonomy
Speciality
Code
Description
License number
State
364SA2100X
Acute Care Clinical Nurse Specialist
Primary
13033749011 74471
KS
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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