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NPI Code Detail

MEDICARE: LISA ANN BERG CRNP

MEDICARE: LISA ANN BERG CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP2300XPrimary Care Nurse PractitionerSP016357PA
2363LG0600XGerontology Nurse PractitionerSP016357PA
3363LP0808XPsychiatric/Mental Health Nurse PractitionerSP016357PA

General Provider Information

NPI Number : 1477006534
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA ANN BERG CRNP
Provider Business Mailing Address
First Line : 4000 LINGLESTOWN RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17112-1017
Country : US
Telephone Number : 717-231-8867
Fax Number : 717-221-5219
Provider Business Practice Location Address
First Line : 4000 LINGLESTOWN RD
Second Line :
City : HARRISBURG
State : PA
Zip : 17112-1017
Country : US
Telephone Number : 717-231-8867
Fax Number : 717-221-5219
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/25/2016
Last Update Date : 01/13/2026

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