Alynn Ann Berg

Individual provider Active NPI Pediatric Nurse Practitioner · Ashland, KY

NPI 1215656459 · NPPES record last updated Aug 23, 2022

Key facts

NPI
1215656459
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
3008404 (KY)
Practice address
4700 Southern Hills Dr
Ashland, KY 41102-9203
Phone
(832) 928-3863
NPI assigned
Aug 23, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1138022KYMDPediatric Registered Nurse
3008404KYMDPediatric Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 1138022 KY
Pediatric Nurse Practitioner 363LP0200X 3008404 KY Yes

Addresses

Primary practice location

4700 Southern Hills Dr
Ashland, KY 41102-9203

Mailing address

4700 Southern Hills Dr
Ashland, KY 41102-9203
Phone (832) 928-3863

Other providers in Ashland, KY

All providers in Ashland, KY · Pediatric Nurse Practitioner in Kentucky

Sources for this page

Verify at the official NPI Registry.