Individual
MR. JOHN DENNIS BERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA APNP
Contact information
Practice address
4936 ORMOND BEACH CT, OSHKOSH, WI 54904-9342
(920) 410-0472
(920) 235-8915
Mailing address
4936 ORMOND BEACH CT, OSHKOSH, WI 54904-9342
(920) 410-0472
(920) 235-8915
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
67892-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31946
AANA CERTIFICATION
WI
01
—
383-033
APNP
—
05
—
43299100
—
WI
01
—
67892-030
NURSING LICENSE
WI
Enumeration date
11/20/2005
Last updated
07/08/2007
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