Provider Demographics
NPI:1497224224
Name:BERG-HOOKER, CIMBERLY FAYE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CIMBERLY
Middle Name:FAYE
Last Name:BERG-HOOKER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CIMBERLY
Other - Middle Name:FAY
Other - Last Name:BERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:2033 LAKESIDE ST
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ND
Mailing Address - Zip Code:58703-0894
Mailing Address - Country:US
Mailing Address - Phone:701-720-0737
Mailing Address - Fax:
Practice Address - Street 1:310 2ND AVE EAST
Practice Address - Street 2:
Practice Address - City:WESTHOPE
Practice Address - State:ND
Practice Address - Zip Code:58793-4033
Practice Address - Country:US
Practice Address - Phone:701-245-6638
Practice Address - Fax:701-534-0116
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-22
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR30392363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner