Provider Demographics
NPI:1669709903
Name:ROSS-BERKE, LAURIE DORINE (CNM/ARNP)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:DORINE
Last Name:ROSS-BERKE
Suffix:
Gender:F
Credentials:CNM/ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10535 EL CABALLO CT
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-2715
Mailing Address - Country:US
Mailing Address - Phone:561-495-8865
Mailing Address - Fax:561-495-8865
Practice Address - Street 1:9970 CENTRAL PARK BLVD.
Practice Address - Street 2:SUITE 206
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33428
Practice Address - Country:US
Practice Address - Phone:561-488-3128
Practice Address - Fax:561-482-5952
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL1019862363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology