Individual
DIANE BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1344 S APOLLO BLVD, STE #301, MELBOURNE, FL 32901-3183
(321) 676-2353
(321) 951-9267
Mailing address
1344 S APOLLO BLVD, STE #301, MELBOURNE, FL 32901-3183
(321) 676-2353
(321) 951-9267
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP 2722652
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ARNP 2722652
ADV REG NURSE PRACTIONER
FL
Enumeration date
08/16/2006
Last updated
07/08/2007
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