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Individual

MS. VICKI LYNNE BERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
701 LEWISTON ST., ST. MARY'S HOSPITAL & CLINICS, COTTONWOOD, ID 83522-0137
(208) 962-3267
(208) 962-2313
Mailing address
PO BOX 137 701 LEWISTON ST, ST. MARY'S HOSPITAL & CLINICS, COTTONWOOD, ID 83522-0137
(208) 962-3267
(208) 962-2313

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
N-19516
ID
163WD0400X
Diabetes Educator Registered Nurse
R59893
NM

Other

Enumeration date
03/08/2007
Last updated
07/17/2013
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