DR. NICOLE ELIZABETH BERG (NPI# 1700360492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700360492 |
| Entity Type | Individual |
| Full Name | DR. NICOLE ELIZABETH BERG |
| Other Name | NICOLE ELIZABETH GAPP |
| Credential | CNP |
| Practice Address |
3033 Excelsior Blvd Ste 465 Minneapolis MN 55416-3372 |
| Mailing Address |
280 Smith Ave N Saint Paul MN 55102-2424 |
| Practice Telephone | 6125479990 |
| Mailing Telephone | 6512415958 |
| Enumeration Date | 2018-09-19 |
| Last Update Date | 2019-06-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 6156 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
6156 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 280 Smith Ave N Ste 450, Saint Paul, MN 551022481 | 6512415958 | 6512415958 |
| 621 W Lake St Ste 350, Minneapolis, MN 554082952 | 6125479990 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922473149 | Nicole Berg | Dietitian, Registered | 12 S 8th St, Yakima, WA 98901-3020 | 2015-12-14 |
| 1083037105 | Nicole Berg | Occupational Therapist | 836 Ritchie Hwy, Suite 6, Severna Park, MD 21146-4126 | 2014-01-24 |
| Street Address |
3033 EXCELSIOR BLVD STE 465 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55416-3372 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629371836 | Shawn Lynn Hebert | Counselor | 3033 Excelsior Blvd Ste 465, Minneapolis, MN 55416-3372 | 2010-12-09 |
| 1609355163 | Lyn-lake Psychotherapy and Wellness, Ltd. | Counselor | 3033 Excelsior Blvd Ste 465, Minneapolis, MN 55416-3372 | 2018-08-07 |
| 1821516139 | Nina Hickman | Counselor | 3033 Excelsior Blvd Ste 465, Minneapolis, MN 55416-3372 | 2017-09-07 |
| 1144664707 | Kamila Malgorzata Robinson | Counselor | 3033 Excelsior Blvd Ste 465, Minneapolis, MN 55416-3372 | 2013-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841803970 | Kelsey Olson | Nurse Practitioner | 2450 Riverside Ave Fl 9, Minneapolis, MN 55454-1450 | 2020-08-28 |
| 1396373932 | Hayley Starr Gifford | Nurse Practitioner | 33 105th Ave Nw, Minneapolis, MN 55448-5044 | 2020-03-30 |
| 1225535701 | Karissa Dougherty | Nurse Practitioner | 2200 E Franklin Ave # 199, Minneapolis, MN 55404 | 2018-04-10 |
| 1831646108 | Ingrid Estephan | Nurse Practitioner | 2929 21st Ave S Apt 301, Minneapolis, MN 55407-4515 | 2016-09-05 |
| 1730532631 | Allina Health System | Nurse Practitioner | 913 E 26th St Ste 305, Minneapolis, MN 55404-4515 | 2016-07-15 |
| 1619376860 | Amy Cooley | Nurse Practitioner | 800 E 28th St # H2100, Minneapolis, MN 55407 | 2014-08-13 |
| 1710265368 | Kimberly Dawn Moore | Nurse Practitioner | 814 South 3rd Street, Minneapolis, MN 55415 | 2011-08-01 |
| 1164700878 | Katherine Casey Martin Caughel | Nurse Practitioner | Hcmc, 701 Park Ave, Surgery Department, P-5, Minneapolis, MN 55415-1623 | 2011-07-29 |
| 1386951358 | Jody Michelle Schoenecker | Nurse Practitioner | 615 1st Ave Ne Ste 310, Minneapolis, MN 55413-2419 | 2010-09-10 |
| 1043543093 | Therese Mary Maas | Nurse Practitioner | 909 Fulton St Se Ste 300, Minneapolis, MN 55455 | 2009-09-09 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55416 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.