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Individual

LAURA BETH BERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-3000
(248) 964-8448
Mailing address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-3000
(248) 964-8448

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704265908
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1295301133
MI
05
1780923128
MI
05
1962463133
MI
Enumeration date
11/24/2013
Last updated
10/23/2024
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