Individual
MARY CLARE BERGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1085 N MAIN ST, PROVIDENCE, RI 02904
(401) 415-4618
(401) 415-4348
Mailing address
1085 N MAIN ST, PROVIDENCE, RI 02904-5719
(401) 415-4618
(401) 415-4348
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN00021
RI
Other
Enumeration date
06/07/2013
Last updated
11/12/2019
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