Berry, Lillian M
Berry, Lillian M is an individual health care provider with primary practice located at 444 W Osborn Rd Suite 200, Phoenix AZ 85013-3814. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Berry, Lillian M can be contacted via phone (602) 230-1400.Contact Information
Primary practice address
444 W Osborn Rd Suite 200
Phoenix AZ 85013-3814
Phone: (602) 230-1400
Fax: (602) 230-7676
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 1959 | Arizona |
Profile Details
| NPI number | 1619947850 |
|---|---|
| LBN Legal business name | Berry, Lillian M |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Mar 14th, 2014 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619947850 | NPPES |
| Arizona | MEDICAID | 454025 | |
| Arizona | Other | 3Z3956 |
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