Berry, Katherine E
Berry, Katherine E is an sole proprietor health care provider with primary practice located at 12000 Stone Lake Rd Jicarilla Apache Health Care Facility, Ihs, Dulce NM 87528-0000. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Berry, Katherine E can be contacted via phone (575) 759-3291.Contact Information
Primary practice address
12000 Stone Lake Rd Jicarilla Apache Health Care Facility, Ihs
Dulce NM 87528-0000
Phone: (575) 759-3291
Fax: (575) 759-3651
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dental Hygienist | 124Q00000X | 532 | Wyoming |
Profile Details
| NPI number | 1194834242 |
|---|---|
| LBN Legal business name | Berry, Katherine E |
| Credentials | Registered Dental Hygienist (RDH) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2006 |
| Last updated | Jun 3rd, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194834242 | NPPES |
| New Mexico | Other | HSZ196 | MEDICARE PART B |
| New Mexico | MEDICAID | 000K3526 | MEDICARE PART B |
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