Individual
LAKEITHA LANAY BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3030 ROOSEVELT AVE, SAN ANTONIO, TX 78214-2337
(210) 924-8151
(210) 783-9688
Mailing address
13523 PAXTON BLVD, SAINT HEDWIG, TX 78152-0497
(785) 210-5152
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
0024174876
VA
363LG0600X
Gerontology Nurse Practitioner
0024174876
VA
363LG0600X
Gerontology Nurse Practitioner
Primary
1128046
TX
363LP2300X
Primary Care Nurse Practitioner
0024174876
VA
Other
Enumeration date
06/07/2017
Last updated
03/09/2026
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