Provider Demographics
NPI:1346133832
Name:BERRY, KALONNI NICOLE (LPN)
Entity type:Individual
Prefix:
First Name:KALONNI
Middle Name:NICOLE
Last Name:BERRY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 ALLWOOD DR APT B
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1137
Mailing Address - Country:US
Mailing Address - Phone:484-892-1952
Mailing Address - Fax:484-892-1952
Practice Address - Street 1:1925 ALLWOOD DR APT B
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-1137
Practice Address - Country:US
Practice Address - Phone:484-892-1952
Practice Address - Fax:484-892-1952
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-02
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPA290038164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty