Individual
AMY MARIE BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1615 MAPLE LANE, ASHLAND, WI 54806
(715) 685-6010
(719) 368-6872
Mailing address
1615 MAPLE LANE, ASHLAND, WI 54806
(715) 685-6010
(719) 368-6872
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2775
CO
363AM0700X
Medical Physician Assistant
2775
CO
363AS0400X
Surgical Physician Assistant
2775
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78601371
—
CO
05
—
CO305010
—
CO
Enumeration date
01/11/2008
Last updated
07/09/2019
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