Individual
KELLY JO BERGEVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6320 N. 70TH PLZ, OMAHA, NE 68104-1074
(402) 573-3761
(402) 573-3780
Mailing address
6320 N. 70TH PLZ, OMAHA, NE 68104-1074
(402) 573-3761
(402) 573-3780
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
114925
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10028320300
—
NE
Enumeration date
07/27/2023
Last updated
02/10/2026
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