DEZIRAE E BERRY NP-C NPI 1740994268

NPI Information

NPI: 1740994268
Provider Name: DEZIRAE E BERRY, NP-C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1522 17TH ST
LEWISTON, ID
ZIP 83501
Phone: (208) 743-8416
Get Directions

Dezirae E Berry, NP-C is a family nurse practitioner in Lewiston, ID with 1 years of experience. Dezirae E Berry, NP-C NPI is 1740994268. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1522 17TH ST
LEWISTON, ID
ZIP 83501-652
Phone: (208) 743-8416
Fax: (208) 743-4642

The NPI 1740994268 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/9/2023 and was last updated on 5/22/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		55464	IDAHO	No
2	363LF0000X	Nurse Practitioner	Family	N361446320	WASHINGTON	No
3	363LF0000X	Nurse Practitioner	Family	55464	IDAHO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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