Provider Demographics
NPI:1124878566
Name:BERRY, JULIA FRANCES (PA-C)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:FRANCES
Last Name:BERRY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 PHILOSOPHERS TER
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1715
Mailing Address - Country:US
Mailing Address - Phone:443-215-5353
Mailing Address - Fax:833-615-2165
Practice Address - Street 1:126 PHILOSOPHERS TER
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1715
Practice Address - Country:US
Practice Address - Phone:443-215-5353
Practice Address - Fax:833-615-2165
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0009359363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant