Individual
MRS. AILEEN ELIZABETH BERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1800 CAMELOT DR STE 300, VIRGINIA BEACH, VA 23454-2440
(757) 321-3300
(757) 321-3330
Mailing address
230 CLEARFIELD AVE STE 124, VIRGINIA BEACH, VA 23462-1832
(757) 321-3383
(573) 213-3330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110003549
VA
363A00000X
Physician Assistant
013890
NY
363A00000X
Physician Assistant
PA2523
TN
363AM0700X
Medical Physician Assistant
Primary
0110003549
VA
363AS0400X
Surgical Physician Assistant
2508
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003130402
—
VA
Enumeration date
03/15/2010
Last updated
07/11/2025
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