Individual
LISA MARIE BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
627 NORWICH SALEM TPKE UNIT 2, OAKDALE, CT 06370-1066
(860) 222-0949
(888) 326-5828
Mailing address
627 NORWICH SALEM TPKE UNIT 2, OAKDALE, CT 06370-1066
(860) 222-0949
(203) 503-3254
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4923
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235900
—
CT
Enumeration date
02/10/2012
Last updated
11/15/2021
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