Provider Demographics
NPI:1427834860
Name:BERRY, ELIZABETH DANIELLE (DNP, APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DANIELLE
Last Name:BERRY
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-2109
Mailing Address - Country:US
Mailing Address - Phone:864-415-9796
Mailing Address - Fax:
Practice Address - Street 1:104 N DANIEL MORGAN AVE STE 105
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29306-2363
Practice Address - Country:US
Practice Address - Phone:864-365-2729
Practice Address - Fax:864-383-5093
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27505363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health