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General NPI Number Information
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NPI Number | 1629051966
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Entity Type | Individual
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Provider Name | KIMBERLY G. BERGERON M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 10/15/2019
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Provider Practice Location Address
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Address Line | 730 COOL SPRINGS BLVD
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City | FRANKLIN
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State | TN
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Zip | 37067-7289
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Country | US
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Telephone | 800-918-8924
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Fax |
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Provider Business Mailing Address
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Address Line | 2132 SAND DOLLAR CIR
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City | LONGMONT
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State | CO
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Zip | 80503-7958
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Country | US
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Telephone | 720-526-9470
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 47492
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 47374
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License Number State | CO
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