Organization
MNMIDWIFE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA JO ANNE BERGERON TM (MIDWIFE)
(651) 329-4514
Entity
Organization
Contact information
Practice address
16930 CHISHOLM ST NE, HAM LAKE, MN 55304-4923
(651) 329-4514
Mailing address
16930 CHISHOLM ST NE, HAM LAKE, MN 55304-4923
(651) 329-4514
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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