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General NPI Number Information
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NPI Number | 1689546640
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Entity Type | Individual
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Provider Name | SARAH BERGSTROM NP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 09/19/2025
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Provider Practice Location Address
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Address Line | 1050 E BROADWAY
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City | MONONA
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State | WI
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Zip | 53716-4023
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Country | US
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Telephone | 608-287-5899
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Fax |
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Provider Business Mailing Address
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Address Line | 7974 UW HEALTH CT
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City | MIDDLETON
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State | WI
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Zip | 53562-5531
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Country | US
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Telephone |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 17156-33
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License Number State | WI
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