Abby Bergman, LPN

Individual provider Active NPI Licensed Practical Nurse · Sidney, OH

NPI 1295987725 · NPPES record last updated Oct 15, 2008

Key facts

NPI
1295987725
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN128039 (OH)
Practice address
500 E Court St
Sidney, OH 45365-2810
Phone
(937) 492-8080
Fax
(937) 492-6971
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PN128039OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN128039 OH Yes

Addresses

Primary practice location

500 E Court St
Sidney, OH 45365-2810

Mailing address

500 E Court St
Sidney, OH 45365-2810
Phone (937) 492-8080

Other identifiers

IdentifierTypeStateIssuer
PN128039OtherOHLICENSE

Other providers in Sidney, OH

All providers in Sidney, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.