Lisa Bergendahl

Individual provider Active NPI Medical-Surgical Registered Nurse · South Weymouth, MA

NPI 1376472472 · NPPES record last updated May 15, 2026

Key facts

NPI
1376472472
Entity type
Individual (NPI type 1)
Primary specialty
Medical-Surgical Registered Nurse 163WM0705X
License
RN (MA)
Practice address
55 Fogg Rd
South Weymouth, MA 02190-2432
Phone
(781) 624-8992
NPI assigned
May 15, 2026
Sex
Unspecified or another gender identity
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
RNMAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X RN MA Yes

Addresses

Primary practice location

55 Fogg Rd
South Weymouth, MA 02190-2432

Mailing address

55 Fogg Rd
South Weymouth, MA 02190-2432
Phone (781) 624-8992

Other providers in South Weymouth, MA

All providers in South Weymouth, MA · Medical-Surgical Registered Nurse in Massachusetts

Sources for this page

Verify at the official NPI Registry.