Individual
MS. MYRA LEA BERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
800 W FORREST AVE, EUFAULA, OK 74432-3249
(918) 689-2547
(918) 689-1127
Mailing address
800 W FORREST AVE, EUFAULA, OK 74432-3249
(918) 689-2547
(918) 689-1127
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
71865
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200335460A
—
OK
Enumeration date
12/28/2010
Last updated
07/11/2013
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