Individual
TERESA BERGEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
209 E CHIPPEWA ST, MT PLEASANT, MI 48858-1609
(989) 772-1261
Mailing address
17007 10TH AVE, MARION, MI 49665-8127
(231) 878-7150
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703082273
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4703082273
LICENSED PRACTICAL NURSE
MI
Enumeration date
03/30/2015
Last updated
03/30/2015
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