Individual provider · NPI-1

Kimberly Lynn Berg, NP

Nurse Practitioner, Pediatrics · Saint Paul, MN

NPI number1255353843
StatusActive
Last updated in NPPESMay 4, 2011

Details

NPI
1255353843
Entity type
Individual (NPI-1)
Name
Kimberly Lynn Berg
Credential
NP
Sex
Female
Sole proprietor
No
Enumeration date
Jul 24, 2006
Last updated
May 4, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, PediatricsR 123060-4MNYes

Practice location

225 Smith Ave N Ste 201
Saint Paul, MN 55102-2697

Phone 651-241-5290 · Fax 651-241-5248

Mailing address

225 Smith Ave N Ste 201
Saint Paul, MN 55102-2697

Phone 651-241-5290 · Fax 651-241-5248

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