Provider Demographics
NPI:1407180839
Name:BERGERON, SARA FRANCES (MS, ATC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:FRANCES
Last Name:BERGERON
Suffix:
Gender:F
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 RICHARD JONES RD APT A207
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2946
Mailing Address - Country:US
Mailing Address - Phone:615-584-5227
Mailing Address - Fax:
Practice Address - Street 1:2601 JESS NEELY DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2039
Practice Address - Country:US
Practice Address - Phone:615-584-5227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN13352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer