Individual
EMILY BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
820 JORDAN ST STE 201, SHREVEPORT, LA 71101-4518
(318) 221-0399
(318) 221-1940
Mailing address
820 JORDAN ST STE 201, SHREVEPORT, LA 71101-4518
(318) 221-0399
(318) 221-1940
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
321252
LA
Other
Enumeration date
10/30/2019
Last updated
10/30/2019
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