Individual
AMANDA BERGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP
Contact information
Practice address
3231 S NATIONAL AVE STE 250, SPRINGFIELD, MO 65807-7304
(417) 885-0827
Mailing address
3231 S NATIONAL AVE STE 250, SPRINGFIELD, MO 65807-7304
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017019296
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578093266
—
MO
Enumeration date
06/14/2017
Last updated
02/08/2018
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