Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner | |
Child & Adolescent Psychiatry |
2084P0804X | 86 | Physician/Neuropsychiatry | |
Geriatric Psychiatry |
2084P0805X | 86 | Physician/Neuropsychiatry | |
Psychiatric/Mental Health |
363LP0808X | 50 | Nurse Practitioner | |
Psychiatry |
2084P0800X | 26 | Physician/Psychiatry |
| NPI # | 1013525187 |
| LBN Legal business name | KERSHAW PRIMARY CARE AND WEIGHT LOSS, LLC |
| Authorized official | VALARIE KERSHAW-BERRY - (OVER/NURSE PRACTITIONER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 07/15/2020 |
| Last updated | 05/13/2025 - More than a year ago |
| Identifiers | n/a |
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