Berg, Abby R.

Berg, Abby R. is an individual health care provider with primary practice located at 2600 Greenbush St , Lafayette IN 47904-2477. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Berg, Abby R. can be contacted via phone (765) 448-8000.

Contact Information

Primary practice address
2600 Greenbush St Lafayette IN 47904-2477
Phone: (765) 448-8000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 71003337A Indiana

Profile Details

NPI number 1558601849
LBN Legal business name Berg, Abby R.
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2013
Last updated May 15th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558601849 NPPES
Indiana Other 000000805893 ANTHEM PROVIDER NUMBER
Indiana MEDICAID 201138970 ANTHEM PROVIDER NUMBER

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