Individual
AVNI BERGUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2109 HAMILTON RD STE 217, OKEMOS, MI 48864-1700
(517) 580-0575
(517) 917-0826
Mailing address
2109 HAMILTON RD STE 217, OKEMOS, MI 48864-1700
(517) 580-0575
(517) 917-0826
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704293729
MI
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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