Berry, Mary Wait

Berry, Mary Wait is an sole proprietor health care provider with primary practice located at 11803 Jefferson Ave Ste 235 , Newport News VA 23606-2565. 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, Mary Wait can be contacted via phone (757) 594-1806.

Contact Information

Primary practice address
11803 Jefferson Ave Ste 235 Newport News VA 23606-2565
Phone: (757) 594-1806
Fax: (757) 510-9079
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024164915 Virginia

Profile Details

NPI number 1033196134
LBN Legal business name Berry, Mary Wait
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 29th, 2005
Last updated Jun 7th, 2024 - about 2 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 1033196134 NPPES
Virginia Other 500026470 RAILROAD MEDICARE
Virginia MEDICAID 7790660 RAILROAD MEDICARE

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