Individual
KIMBERLY A BERGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
433 ST MICHAELS DR, SANTA FE, NM 87505
(505) 988-1232
(505) 984-1603
Mailing address
433 ST MICHAELS DR, SANTA FE, NM 87505
(505) 988-1232
(505) 984-1603
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
81PA001
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10003927
LOVELACE
—
01
—
1699939
UHC
—
Enumeration date
12/27/2005
Last updated
11/21/2007
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