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NPI Code Detail

MEDICARE: CARL ERIK BERGESON APRN

MEDICARE: CARL ERIK BERGESON APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse PractitionerAPRN03208RI

General Provider Information

NPI Number : 1659093854
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARL ERIK BERGESON APRN
Provider Business Mailing Address
First Line : 15 LA SALLE SQ
Second Line :
City : PROVIDENCE
State : RI
Zip : 02903-1814
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11 FRIENDSHIP ST
Second Line :
City : NEWPORT
State : RI
Zip : 02840-2209
Country : US
Telephone Number : 401-846-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2022
Last Update Date : 03/13/2026

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Directions to “ CARL ERIK BERGESON APRN” Practice Location

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