AMY E BERG PMHNP NPI 1205204799

NPI Information

NPI: 1205204799
Provider Name: AMY E BERG, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
620 NE 2ND ST
GRESHAM, OR
ZIP 97030
Phone: (971) 274-3757
Get Directions

Amy E Berg, PMHNP is a psychiatric/mental health nurse practitioner in Gresham, OR. Amy E Berg, PMHNP NPI is 1205204799. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

620 NE 2ND ST
GRESHAM, OR
ZIP 97030-514
Phone: (971) 274-3757
Fax: (503) 912-5740

The enumeration date for this NPI number is 9/14/2015 and was last updated on 11/13/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163W00000X	Registered Nurse		RN60333379	WASHINGTON	No
2	163W00000X	Registered Nurse		200540554RN	OREGON	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	AP61012022	WASHINGTON	No
4	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	201506290NP-PP	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	500715774	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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