Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 11104 | WI |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 209020865 | IL |
NPI | 1003444837 |
---|---|
Provider Name | Ashley N Berka |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715-1507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2020 |
Last Update Date | 02/12/2021 |