Provider Demographics
NPI:1861500316
Name:BERGER, SHERI MICHELLE (APRN, CPNP)
Entity Type:Individual
Prefix:MISS
First Name:SHERI
Middle Name:MICHELLE
Last Name:BERGER
Suffix:
Gender:F
Credentials:APRN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N CAUSEWAY BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3209
Mailing Address - Country:US
Mailing Address - Phone:985-674-2227
Mailing Address - Fax:985-674-1227
Practice Address - Street 1:1100 N CAUSEWAY BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3209
Practice Address - Country:US
Practice Address - Phone:985-674-2227
Practice Address - Fax:985-674-1227
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2011-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04653363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS08880206Medicaid
LA1712523Medicaid
LA3B3787061Medicare PIN
MS08880206Medicaid