Healthcare Provider Details

I. General information

NPI: 1760438212
Provider Name (Legal Business Name): JUNE M BJERREGAARD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 01/19/2023
Certification Date: 01/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 OLD FERRY RD
BRISTOL RI
02809-2921
US

IV. Provider business mailing address

1 OLD FERRY RD
BRISTOL RI
02809-2921
US

V. Phone/Fax

Practice location:
  • Phone: 401-254-3388
  • Fax: 401-254-3305
Mailing address:
  • Phone: 401-254-3388
  • Fax: 401-254-3305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number25701
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: