Healthcare Provider Details

I. General information

NPI: 1598047847
Provider Name (Legal Business Name): DANIELLE NICOLE BERGER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2011
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 EAST MEDICAL CENTER DR FLOOR 3 CARDIOVASCULAR CENTER
ANN ARBOR MI
48109-5856
US

IV. Provider business mailing address

2215 FULLER RD
ANN ARBOR MI
48105-2303
US

V. Phone/Fax

Practice location:
  • Phone: 888-287-1082
  • Fax: 734-232-4505
Mailing address:
  • Phone: 734-769-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number21206
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704262479
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: