Individual provider · NPI-1

Jenna Norene Berg

Specialist/Technologist, Athletic Trainer · Minneapolis, MN

NPI number1265978282
StatusActive
Last updated in NPPESJan 19, 2021

Details

NPI
1265978282
Entity type
Individual (NPI-1)
Name
Jenna Norene Berg
Sex
Female
Sole proprietor
No
Enumeration date
Jan 14, 2017
Certification date
Jan 19, 2021
Last updated
Jan 19, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer––Yes

Practice location

909 Fulton St Se
Minneapolis, MN 55455-4800

Phone 612-676-5952

Mailing address

909 Fulton St Se
Minneapolis, MN 55455-4800

Phone 612-676-5052

Other practice locations

20523 Kalmeadow Ct
Lakeville, MN 55044-6705

Phone 952-288-3187

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