Healthcare Provider Details

I. General information

NPI: 1962710905
Provider Name (Legal Business Name): FRANCIA BERGADO BIRULIN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2010
Last Update Date: 09/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 CENTRAL AVENUE NAVAL HEALTH CLINIC HAWAII
PEARL HARBOR HI
96860
US

IV. Provider business mailing address

91-929 NOHOIHOEWA PL
EWA BEACH HI
96706-4031
US

V. Phone/Fax

Practice location:
  • Phone: 831-512-2662
  • Fax:
Mailing address:
  • Phone: 831-512-2662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WA2000X
TaxonomyAdministrator Registered Nurse
License Number44318
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: