Provider Demographics
NPI:1609624337
Name:BEIRIGER, BERLIN REBECCA (PA-C)
Entity type:Individual
Prefix:
First Name:BERLIN
Middle Name:REBECCA
Last Name:BEIRIGER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BERLIN
Other - Middle Name:REBECCA
Other - Last Name:VAN NESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:310 COUNTY ROAD 14
Mailing Address - Street 2:
Mailing Address - City:DEL NORTE
Mailing Address - State:CO
Mailing Address - Zip Code:81132-8758
Mailing Address - Country:US
Mailing Address - Phone:719-657-2510
Mailing Address - Fax:
Practice Address - Street 1:310 COUNTY ROAD 14
Practice Address - Street 2:
Practice Address - City:DEL NORTE
Practice Address - State:CO
Practice Address - Zip Code:81132-8758
Practice Address - Country:US
Practice Address - Phone:719-657-2510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2025-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
COPA.0009257363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program