Provider Demographics
NPI:1437927332
Name:BERG, BETH ALLLISON (RN, BSN)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ALLLISON
Last Name:BERG
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ALLISON
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13569 N 141ST LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85379-8733
Mailing Address - Country:US
Mailing Address - Phone:801-513-0643
Mailing Address - Fax:
Practice Address - Street 1:13569 N 141ST LN
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-8733
Practice Address - Country:US
Practice Address - Phone:801-513-0643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program