Individual
SAMUEL BERGENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
801 W MAPLE ST, FARMINGTON, NM 87401-5630
(505) 609-2000
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
63318
NM
367500000X
Certified Registered Nurse Anesthetist
MB2468470
WA
367500000X
Certified Registered Nurse Anesthetist
N-26821
ID
Other
Enumeration date
02/08/2007
Last updated
02/28/2025
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