| Doctor Name: | MARY BERRY |
| NPI Number: | 1033196134 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | N.P. |
| License Number: | 0024164915 |
| Business Practice Address: | 704 Thimble Shoals Blvd Suite 700 Newport News, VA - 236064544 |
| Business Phone Number: | 7578732000 |
| Business Fax Number: | |
| Mailing Address: | 704 Thimble Shoals Blvd, Suite 700 NEWPORT NEWS |
| State: | VA |
| Postal Code: | 236064544 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/29/2005 |
| NPI Last Update Date: | 10/25/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 0024164915 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |