Individual
ROSE BERGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1000 HIGHWAY 12, HETTINGER, ND 58639-7530
(701) 567-4561
(701) 567-6361
Mailing address
1000 HIGHWAY 12, HETTINGER, ND 58639-7530
(701) 567-4561
(701) 567-6361
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PAC0235
ND
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
PAC0235
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19144
BLUE CROSS OF NORTH DAKOT
ND
Enumeration date
09/25/2006
Last updated
02/22/2019
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