Individual
NOELLE JO BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(320) 298-5636
Mailing address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0978
ND
Other
Enumeration date
04/05/2022
Last updated
11/07/2022
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