NPI 1063153013 · live from the CMS NPI Registry
Noelle Jo Berg, PA-C
Physician Assistant in Fargo, ND. National Provider Identifier 1063153013, active.
NPI record
| NPI | 1063153013 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 1702 University Dr S, Fargo, ND 58103 |
| Practice phone | 320-298-5636 |
| Enumerated | April 5, 2022 |
| Last updated | November 7, 2022 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | PAC0978 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.