Provider Demographics
NPI:1588916936
Name:BERRY, TRINA R (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MS
First Name:TRINA
Middle Name:R
Last Name:BERRY
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Gender:F
Credentials:NURSE PRACTITIONER
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Mailing Address - Street 1:856 J CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1318
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1000 OLD DENBIGH BLVD
Practice Address - Street 2:SUITE 1020A
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-2017
Practice Address - Country:US
Practice Address - Phone:757-875-2050
Practice Address - Fax:757-875-2070
Is Sole Proprietor?:No
Enumeration Date:2012-10-10
Last Update Date:2021-10-06
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Provider Licenses
StateLicense IDTaxonomies
NYF305791-1363LA2200X
VA0024170397363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health