Berka, Kristin Marie
Berka, Kristin Marie is an individual health care provider with primary practice located at 15830 Ballantyne Medical Pl Ste 100 , Charlotte NC 28277-0762. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is her primary health care specialty. Berka, Kristin Marie can be contacted via phone (704) 341-0090.Contact Information
Primary practice address
15830 Ballantyne Medical Pl Ste 100
Charlotte NC 28277-0762
Phone: (704) 341-0090
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 1109 | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 103380 | North Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 103380 | North Carolina |
Profile Details
| NPI number | 1609837814 |
|---|---|
| LBN Legal business name | Berka, Kristin Marie |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2006 |
| Last updated | Oct 8th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609837814 | NPPES |
| North Carolina | Other | 85246 | BLUECROSS BLUESHIELD |
| North Carolina | MEDICAID | 7985246 | BLUECROSS BLUESHIELD |
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