AMY BERGERON (NPI# 1417944455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417944455 |
| Entity Type | Individual |
| Full Name | AMY BERGERON |
| Credential | FNP |
| Practice Address |
190 Stetson Rd Auburn ME 04210-7813 |
| Practice Telephone | 2077847388 |
| Practice Fax Number | 2077952043 |
| Mailing Telephone | 2077847388 |
| Mailing Fax Number | 2077952043 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2017-12-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | AP081508 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
CNP81508 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 266180099 | 05 |
| Street Address |
190 STETSON RD |
| City | AUBURN |
| State | ME |
| Zip Code | 04210-7813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831186972 | Family Healthcare Associates Pa | Family Medicine | 190 Stetson Rd, Auburn, ME 04210-7813 | 2005-10-04 |
| 1477107647 | Rebecca P Sirka | Family Medicine | 190 Stetson Rd, Auburn, ME 04210-7813 | 2019-07-26 |
| 1174992788 | Martina M Sullivan | Social Worker | 190 Stetson Rd, Auburn, ME 04210-7813 | 2015-09-24 |
| 1174909675 | Amy Ouellette | Nurse Practitioner | 190 Stetson Rd, Auburn, ME 04210-7813 | 2015-08-06 |
| 1679884522 | Adam Duquette | Family Medicine | 190 Stetson Rd, Auburn, ME 04210-7813 | 2010-06-25 |
| 1427288810 | Taylor C Butterfield | Physician Assistant | 190 Stetson Rd, Auburn, ME 04210-7813 | 2009-07-20 |
| 1447288808 | Jeffrey A Wall | Family Medicine | 190 Stetson Rd, Auburn, ME 04210-7813 | 2006-06-28 |
| 1346237336 | Michael Rifkin | Family Medicine | 190 Stetson Rd, Auburn, ME 04210-7813 | 2005-10-04 |
| 1548257603 | Peter H. Elias | Family Medicine | 190 Stetson Rd, Auburn, ME 04210-7813 | 2005-10-04 |
| 1861489882 | Sarah Skelton | Family Medicine | 190 Stetson Rd, Auburn, ME 04210-7813 | 2005-10-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538632245 | Matthew Charles Dove | Specialist/Technologist | 30 Belgrade Ave, Suite A, Auburn, ME 04210 | 2019-01-04 |
| 1851880603 | Dba Central Maine Conditioning Clinic | Massage Therapist | 30 Belgrade Ave Suite A, Auburn, ME 04210 | 2018-05-08 |
| 1285189654 | Kimberly Ann Boutwell | Nurse Practitioner | 15 Gracelawn Road, Auburn, ME 04210 | 2016-08-16 |
| 1487036554 | Eric Morrow | Specialist/Technologist | 36 Belgrade Ave, Auburn, ME 04210 | 2015-06-24 |
| 1750770152 | Larissa J Brown | Marriage & Family Therapist | 86 Main Sreet, Suite 302, Auburn, ME 04210 | 2015-01-22 |
| 1659771046 | Daniel Fontaine | Pharmacist | 689 Minot Ave., Auburn, ME 04210 | 2014-09-04 |
| 1104236793 | Caitlin White | Occupational Therapist | 415 Rodman Road, Auburn, ME 04210 | 2014-05-05 |
| 1780954883 | Richard Marc Pelletier | Counselor | 24 Dunn Street, Auburn, ME 04210 | 2012-01-05 |
| 1285929026 | Cynthia Morgan | Social Worker | 60 Court St., Auburn, ME 04210 | 2011-06-09 |
| 1972811164 | Wendy Thomas-blais | Social Worker | 229 Center St 2, Auburn, ME 04210 | 2010-09-22 |
| Find all providers in zip 04210 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
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|---|---|---|---|---|
| 1154935658 | Judith A Glover | Nurse Practitioner | 1101 Rock Elm Dr, Auburn, GA 30011-2393 | 2020-09-02 |
| 1568075190 | Carey Webster | Nurse Practitioner | 11775 Education St Ste 210, Auburn, CA 95602-2453 | 2020-08-24 |
| 1043860299 | Kimberly Danner | Nurse Practitioner | 507 Red Bud Ln, Auburn, IL 62615-9357 | 2019-09-18 |
| 1467001214 | Lauren Elizabeth Sabo | Nurse Practitioner | 906 W North St, Auburn, IL 62615-1046 | 2019-09-04 |
| 1952876294 | Modeline Jules | Nurse Practitioner | 125 3rd St Ne Ste 403, Auburn, WA 98002 | 2018-10-12 |
| 1063987162 | Shadiyah S Tawwab | Nurse Practitioner | 1702 Catherine Ct Ste 1a, Auburn, AL 36830-5790 | 2018-10-04 |
| 1801370812 | Catherine Molly Kohl | Nurse Practitioner | 1702 Catherine Ct Ste A, Auburn, AL 36830-5755 | 2018-09-17 |
| 1518443258 | Kelly Elizabeth Cordon | Nurse Practitioner | 77 Nelson St Fl 3, Auburn, NY 13021-1944 | 2018-07-16 |
| 1750873329 | Claire Wakulyaka | Nurse Practitioner | 39 Bryn Mawr Ave, Auburn, MA 01501-1636 | 2018-05-30 |
| 1467963710 | Alissa Marie Dippolito | Nurse Practitioner | 77 Nelson St Ste 310, Auburn, NY 13021-1945 | 2017-10-13 |
| Find all providers in AUBURN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.