Vicki L Berger, P.A.

Individual provider Active NPI Medical Physician Assistant · Roy, UT

NPI 1306821079 · NPPES record last updated Sep 11, 2012

Key facts

NPI
1306821079
Entity type
Individual (NPI type 1)
Primary specialty
Medical Physician Assistant 363AM0700X
License
215310-1206 (UT)
Practice address
5991 S 3500 W
Roy, UT 84067
Phone
(801) 773-8644
Fax
(801) 985-0486
NPI assigned
Dec 14, 2005
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
215310-1206UTMDMedical Physician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 215310-1206 UT Yes

Addresses

Primary practice location

5991 S 3500 W
Roy, UT 84067

Mailing address

2086 N 1700 W
Suite C
Layton, UT 84041
Phone (801) 773-8644

Other names

  • Vicki L Bringhurst Former name

Other providers in Roy, UT

All providers in Roy, UT · Medical Physician Assistant in Utah

Sources for this page

Verify at the official NPI Registry.