Individual
KERA BERGERON
Active
Individual
KERA BERGERON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
179
MS
363AM0700X
Medical Physician Assistant
2248
TN
363AS0400X
Surgical Physician Assistant
179
MS
363AS0400X
Surgical Physician Assistant
Primary
2248
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
179
MS LICENSE
MS
01
—
2248
TN LICENSE
TN
01
—
6186490
BCBS
TN
05
—
Q000115
—
TN
01
—
T08648A
MEDICARE
TN
Enumeration date
10/30/2012
Last updated
10/20/2025
Update your record
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