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Individual
SKYE RAELYNN PORTER BERG
Active
Individual
SKYE RAELYNN PORTER BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
95223197
CA
207RI0011X
Interventional Cardiology Physician
95019889
CA
363L00000X
Nurse Practitioner
Primary
95019889
CA
363LC0200X
Critical Care Medicine Nurse Practitioner
95019889
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
IL
05
—
2211IMAA
—
CA
Enumeration date
04/09/2021
Last updated
03/14/2025
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