Provider Demographics
NPI:1831560747
Name:BERG, LESLEIGH (APRN, NP-C)
Entity type:Individual
Prefix:
First Name:LESLEIGH
Middle Name:
Last Name:BERG
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:841 STEUBENVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:OH
Mailing Address - Zip Code:43725-2301
Mailing Address - Country:US
Mailing Address - Phone:855-692-7247
Mailing Address - Fax:855-692-7247
Practice Address - Street 1:841 STEUBENVILLE AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2301
Practice Address - Country:US
Practice Address - Phone:855-692-7247
Practice Address - Fax:855-692-7247
Is Sole Proprietor?:No
Enumeration Date:2015-10-19
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0027657363LF0000X
OHRN.306938163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAPRN.CNP.0027657Medicaid