Gwen Lea Berry
Individual provider Active NPI Home Health Registered Nurse · Long Prairie, MN
NPI 1497229264 · NPPES record last updated Jan 15, 2019
Key facts
- NPI
- 1497229264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Registered Nurse 163WH0200X
- License
- 1402843 (MN)
- Practice address
- 212 2ND Ave S
Long Prairie, MN 56347-1608 - Phone
- (320) 732-4500
- NPI assigned
- Jan 15, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1402843 | MN | MD | Home Health Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Todd County Social Services | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Registered Nurse | 163WH0200X | 1402843 | MN | Yes |
Addresses
Primary practice location
212 2ND Ave S
Long Prairie, MN 56347-1608
Mailing address
212 2ND Ave S
Long Prairie, MN 56347-1608
Other providers in Long Prairie, MN
- Aleathea Rae Anderson
- Audrey Elissa Brandt Loer
- Samuel Tucker Burns
- Centracare Clinic - Long Prairie
- Centracare Health System - Long Prairie
- Centracare Health System - Long Prairie
All providers in Long Prairie, MN · Home Health Registered Nurse in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.