Individual
HANNA VANDEN BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1500 E SHERMAN BLVD, MUSKEGON, MI 49444-1849
(672) 231-2000
Mailing address
PO BOX 776982, CHICAGO, IL 60677-6982
(231) 672-2119
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011533
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588379762
—
MI
Enumeration date
01/23/2023
Last updated
02/01/2023
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