| Doctor Name: | MS. VICKI LYNNE BERG |
| NPI Number: | 1033240098 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | R59893 |
| Business Practice Address: | 701 Lewiston St. St. Mary's Hospital & Clinics Cottonwood, ID - 835220137 |
| Business Phone Number: | 2089623267 |
| Business Fax Number: | 2089622313 |
| Mailing Address: | Po Box 137 701 Lewiston St, St. Mary's Hospital & Clinics COTTONWOOD |
| State: | ID |
| Postal Code: | 835220137 |
| Phone Number: | 2089623267 |
| Fax Number: | 2089622313 |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 07/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WD0400X |
| License Number: | R59893 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Diabetes Educator |
| Taxonomy Definition: | |