Healthcare Provider Details

I. General information

NPI: 1942776588
Provider Name (Legal Business Name): ALYSSA BERGER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2018
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1339 S FEDERAL BLVD
DENVER CO
80219-4235
US

IV. Provider business mailing address

1339 S FEDERAL BLVD
DENVER CO
80219-4235
US

V. Phone/Fax

Practice location:
  • Phone: 303-602-0000
  • Fax: 303-602-0050
Mailing address:
  • Phone: 303-602-0000
  • Fax: 303-602-0050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number0994042
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0994042
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: