| Doctor Name: | MR. RONALD ARTHUR BERRY |
| NPI Number: | 1285625822 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN, FNP |
| License Number: | 17377.148 |
| Business Practice Address: | 1270 Kotnum Road Warm Springs, OR - 977611209 |
| Business Phone Number: | 5415531196 |
| Business Fax Number: | 5415532457 |
| Mailing Address: | Po Box 1209, WARM SPRINGS |
| State: | OR |
| Postal Code: | 977611209 |
| Phone Number: | 5415531196 |
| Fax Number: | 5415532457 |
| NPI Enumeration Date: | 11/02/2005 |
| NPI Last Update Date: | 03/31/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 17377.148 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |