Individual
RANDI KIRSTEN BERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
805 MAIN AVE S, HARMONY, MN 55939-6625
(507) 886-8888
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
33589
IA
207Q00000X
Family Medicine Physician
Primary
52745
MN
207Q00000X
Family Medicine Physician
54634
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215947
—
IA
05
—
148425700
—
MN
Enumeration date
06/10/2005
Last updated
02/04/2016
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