Provider Demographics
NPI:1760493829
Name:BERGER, KATHERINE JOAN (DPM)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:JOAN
Last Name:BERGER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 O STREET
Mailing Address - Street 2:KATHERINE J BERGER DPM
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-1541
Mailing Address - Country:US
Mailing Address - Phone:402-474-4766
Mailing Address - Fax:402-474-5957
Practice Address - Street 1:3401 O STREET
Practice Address - Street 2:KATHERINE J BERGER DPM
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-1541
Practice Address - Country:US
Practice Address - Phone:402-474-4766
Practice Address - Fax:402-474-5957
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE219213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE480009767OtherRR MEDICARE
U01850Medicare UPIN
NE091289Medicare ID - Type Unspecified