Individual
MARY KAY BERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LNP
Contact information
Practice address
24 CLAY ST, MARTINSVILLE, VA 24112-2810
(276) 632-7128
(276) 632-0127
Mailing address
375 FOXFIRE RD, MARTINSVILLE, VA 24112-7857
(276) 632-7128
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024164726
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004945221
—
VA
Enumeration date
01/06/2006
Last updated
03/07/2023
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