Healthcare Provider Details

I. General information

NPI: 1164619409
Provider Name (Legal Business Name): KATHERINE J. BERGER, D.P.M.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 N BURLINGTON AVE STE 308
HASTINGS NE
68901-4478
US

IV. Provider business mailing address

3401 O ST
LINCOLN NE
68510-1541
US

V. Phone/Fax

Practice location:
  • Phone: 402-462-2331
  • Fax: 402-461-4054
Mailing address:
  • Phone: 402-474-4766
  • Fax: 402-474-5957

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number219
License Number StateNE

VIII. Authorized Official

Name: DR. KATHERINE JOAN BERGER
Title or Position: PODIATRIST
Credential: D.P.M.
Phone: 402-474-4766