Individual
DR. BENJAMIN SCOTT BERGSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
655 SIERRA ROSE DR, RENO, NV 89511-2060
(775) 770-2705
Mailing address
21219 N 38TH PL, PHOENIX, AZ 85050-4963
(480) 369-1976
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN178752
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
228542
AZ
Other
Enumeration date
07/22/2019
Last updated
07/22/2019
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