Berg, Susan L.
Berg, Susan L. is an individual health care provider with primary practice located at 3503 E Frontage Rd , Tampa FL 33607-1742. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Berg, Susan L. can be contacted via phone (813) 586-8187.Contact Information
Primary practice address
3503 E Frontage Rd
Tampa FL 33607-1742
Phone: (813) 586-8187
Fax: (813) 321-6998
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 150718 | Missouri |
Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | 150718 | Missouri |
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APRN9432283 | Florida |
Profile Details
NPI number | 1639210412 |
---|---|
LBN Legal business name | Berg, Susan L. |
Credentials | Family Nurse Practitioner (FNP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 12th, 2007 |
Last updated | Aug 3rd, 2023 - about last year |
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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1639210412 | NPPES |
Missouri | MEDICAID | 428420509 | |
Missouri | Other | 159889758 |
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