Individual
HANNAH JACQUELYN MILLER BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
(816) 302-9939
Mailing address
2401 GILLHAM RD, PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
2022028794
MO
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
2022028794
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200048601
—
MO
Enumeration date
03/31/2015
Last updated
02/25/2026
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