Harlan Bergum, NBCHWC

Individual provider Active NPI Health & Wellness Coach · Tomah, WI

NPI 1679615769 · NPPES record last updated Jun 17, 2024

Key facts

NPI
1679615769
Entity type
Individual (NPI type 1)
Primary specialty
Health & Wellness Coach 171400000X
License
A-3273815
Practice address
500 E Veterans St
Tomah, WI 54660-3105
Phone
(608) 372-3971
NPI assigned
Feb 13, 2007
Sex
Male
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X
Health Educator 174H00000X
Health & Wellness Coach 171400000X A-3273815 Yes

Addresses

Primary practice location

500 E Veterans St
Tomah, WI 54660-3105

Mailing address

405 S Rusk Ave Apt 1
Viroqua, WI 54665-2019
Phone (815) 900-1580

Other practice location 1

405 S Rusk Ave Apt 1
Viroqua, WI 54665-2019
Phone (815) 900-1580

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address Harlan.Bergum@va.gov Direct VETERANS ADMINISTRATION

Other providers in Tomah, WI

All providers in Tomah, WI · Health & Wellness Coach in Wisconsin

Sources for this page

Verify at the official NPI Registry.