Doctor Name: | ELEANOR K BERG |
NPI Number: | 1013009570 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 31685 |
Business Practice Address: | Route 28/55 Grant Memorial Drive Grant Memorial Hospital Petersburg, WV - 26847 |
Business Phone Number: | 3042571026 |
Business Fax Number: | |
Mailing Address: | Route 28/55 Grant Memorial Drive, Grant Memorial Hospital PETERSBURG |
State: | WV |
Postal Code: | 26847 |
Phone Number: | 3042571026 |
Fax Number: | |
NPI Enumeration Date: | 09/29/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | 31685 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WV |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |