Healthcare Provider Details

I. General information

NPI: 1740408301
Provider Name (Legal Business Name): KARI J BERGMAN CST CFA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11907 E HARVARD AVE # B4101
AURORA CO
80014-5480
US

IV. Provider business mailing address

PO BOX 131
BENNETT CO
80102-0131
US

V. Phone/Fax

Practice location:
  • Phone: 720-839-9641
  • Fax: 303-644-5015
Mailing address:
  • Phone: 303-839-9641
  • Fax: 303-644-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: