Nancy Jean Bergey, NURSE PRACTITIONER
Individual provider Active NPI Adult Psychiatric/Mental Health Clinical Nurse Specialist · King, WI
NPI 1760699896 · NPPES record last updated Jan 14, 2014
Key facts
- NPI
- 1760699896
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X
- License
- MB2732178 (WI)
- Practice address
- N2665 County Road QQ
King, WI 54946-0600 - Phone
- (715) 258-5586
- Fax
- (715) 258-0450
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3615 | WI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northland Counseling Services LTD | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 64407 | WI | |
| Adult Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0809X | MB2732178 | WI | Yes |
Addresses
Primary practice location
N2665 County Road QQ
King, WI 54946-0600
Mailing address
N2665 County Road QQ
King, WI 54946-0600
Phone (715) 258-5586
Other providers in King, WI
All providers in King, WI · Adult Psychiatric/Mental Health Clinical Nurse Specialist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.