Individual
JACQUELINE J BERGNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
17000 W NORTH AVE, 104W, BROOKFIELD, WI 53005-4423
(262) 785-7430
(262) 785-7431
Mailing address
17000 W NORTH AVE, 104W, BROOKFIELD, WI 53005-4423
(262) 785-7430
(262) 785-7431
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
5397
WI
363LG0600X
Gerontology Nurse Practitioner
5397
WI
Other
Enumeration date
08/23/2013
Last updated
08/23/2013
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