NPI | 1225169261 |
---|---|
Former Name | ANGELA CHRISTINE BERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704190660) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704190660) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2024-12-10 |