NPI Code Details Logo

NPI 1588225239

NPI 1588225239 : KARI J BERGMAN APRN, CNP : ADA, MN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1588225239
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    KARI J BERGMAN APRN, CNP
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/24/2019
-----------------------------------------------------
    Last Update Date     |    07/23/2019
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    201 9TH ST W 
-----------------------------------------------------
    City                 |    ADA
-----------------------------------------------------
    State                |    MN
-----------------------------------------------------
    Zip                  |    56510-1279
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    218-784-5000
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1702 UNIVERSITY DR S 
-----------------------------------------------------
    City                 |    FARGO
-----------------------------------------------------
    State                |    ND
-----------------------------------------------------
    Zip                  |    58103-4940
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LF0000X
-----------------------------------------------------
    Taxonomy Name        |    Family Nurse Practitioner
-----------------------------------------------------
    License Number       |    6665
-----------------------------------------------------
    License Number State |    MN
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.