Berry, Marian Adale

Berry, Marian Adale is an individual health care provider with primary practice located at 202 Croft St , Carrollton GA 30117-3803. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Berry, Marian Adale can be contacted via phone (770) 834-2255.

Contact Information

Primary practice address
202 Croft St Carrollton GA 30117-3803
Phone: (770) 834-2255
Fax: (770) 834-7100
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN158389 Georgia

Profile Details

NPI number 1659492361
LBN Legal business name Berry, Marian Adale
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 2nd, 2007
Last updated Feb 19th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659492361 NPPES
Georgia MEDICAID 309752602C

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