Provider Demographics
NPI:1285151134
Name:BERGER, CHRISTINE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154-3981
Mailing Address - Country:US
Mailing Address - Phone:972-515-8700
Mailing Address - Fax:214-764-8558
Practice Address - Street 1:104 PLAZA DR
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-3981
Practice Address - Country:US
Practice Address - Phone:972-515-8700
Practice Address - Fax:214-764-8558
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134851363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX382052401Medicaid