Individual
SHAWNA M BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
820 MAPLE ST, CARROLLTON, GA 30117-3626
(678) 390-7915
(678) 390-7901
Mailing address
222 GORDON ST, BREMEN, GA 30110-1519
(770) 537-1234
(770) 537-1237
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN113194
GA
363LF0000X
Family Nurse Practitioner
RN113194
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861915647
GROUP NPI
GA
Enumeration date
09/14/2011
Last updated
03/21/2025
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