Individual
MRS. STEPHANI MICHELLE BERGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4001 DUTCHMANS LN, LOUISVILLE, KY 40207-4714
(502) 893-1000
Mailing address
601 S FLOYD ST, SUITE NUMBER 407, LOUISVILLE, KY 40202-1835
(502) 629-2880
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1113038
KY
Other
Enumeration date
11/10/2010
Last updated
11/10/2010
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