Individual
MS. BOBBI L BERGMOOSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-7000
(207) 973-5042
Mailing address
141 N MAIN ST STE 205, BREWER, ME 04412-2055
(207) 992-4032
(207) 992-4034
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R049891
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079296
CCNA
—
01
—
4704108789
STATE OF MICHIGAN
MI
01
—
R049891
MAINE STATE BOARD OF NURS
ME
Enumeration date
03/28/2008
Last updated
04/29/2013
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