Individual
DUSTIN BERGERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
18701 N 67TH AVE, GLENDALE, AZ 85308-7100
(623) 561-1000
Mailing address
8925 STONECROFT AVE, BATON ROUGE, LA 70810-2677
(985) 691-2503
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
205491
LA
367500000X
Certified Registered Nurse Anesthetist
Primary
317963
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/29/2024
Last updated
12/31/2024
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