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Individual

DR. BENJAMIN BERGESEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1606 N 7TH ST, TERRE HAUTE, IN 47804-2706
(812) 238-7000
Mailing address
505 ELM DR, PLAINFIELD, IN 46168-2113
(317) 503-1795

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28206146A
IN
163W00000X
Registered Nurse
50907
ID
367500000X
Certified Registered Nurse Anesthetist
Primary
28206146A
IN

Other

Enumeration date
12/03/2020
Last updated
02/19/2024
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