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NPI Code Detail

MEDICARE: DIANNE J BERGER NP

MEDICARE: DIANNE J BERGER NP
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
1363LW0102XWomen's Health Nurse Practitioner104808CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1BEN04257724OTHERNCC CERTIFICATION
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942308218
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANNE J BERGER NP
Provider Business Mailing Address
First Line : 1455 DIXON AVE
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-8879
Country : US
Telephone Number : 303-443-8500
Fax Number : 303-413-6325
Provider Business Practice Location Address
First Line : 1455 DIXON AVE
Second Line :
City : LAFAYETTE
State : CO
Zip : 80026-8879
Country : US
Telephone Number : 303-443-8500
Fax Number : 303-413-6325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 12/09/2019

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