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Individual

MRS. SARAH R BERGSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1703 LOCUST AVE, FAIRMONT, WV 26554
(304) 366-6100
(304) 366-2220
Mailing address
1703 LOCUST AVE, FAIRMONT, WV 26554-1320
(304) 366-6100
(304) 366-2220

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APRN83284-NP-C
WV
363LP0200X
Pediatric Nurse Practitioner
APRN83284-NP-C
WV
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
APRN83284NP
WV

Other

Enumeration date
07/19/2017
Last updated
07/21/2022
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