Sally Joan Vande Berg

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP032723 Issued in AZ

Practice address

16323 N Sotol Ave
Tucson, AZ 85739-8966

Phone

(520) 603-0027

NPI assigned

May 7, 2009

Last updated

May 7, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241654400000",
    "number": "1225262041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16323 N SOTOL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857398966",
            "telephone_number": "520-603-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16323 N SOTOL AVE",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857398966",
            "telephone_number": "520-603-0027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDE BERG",
        "first_name": "SALLY",
        "middle_name": "JOAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2009-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AZ",
            "license": "LP032723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul R Vanatta, MD
• Judith A Vance, FNP
• Katherine Therese Vance, PH.D.
• Misty Vancleaf
• Carrie Ann Vancuran, N.P.
• Susan E Vande Geest, PHARM.D.
• Ethan James Vandemark, MD
• Aimee Vanden-Heuvel
• James Justin Vandenberg, PHARMD
• Linda Vandenheuvel

• Licensed Practical Nurse in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Licensed Practical Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.