Individual
KIMBERLY BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3611 N CAMPBELL AVE, TUCSON, AZ 85719-1534
(520) 881-0636
(520) 881-0637
Mailing address
1250 S CLEARVIEW AVE STE 100, MESA, AZ 85209-3378
(480) 988-9108
(480) 813-4460
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP3404
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
465975
—
AZ
01
—
Z169168
MEDICARE PTAN
—
Enumeration date
09/21/2009
Last updated
03/27/2015
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