Provider Demographics
NPI:1477020154
Name:BERGLUND, ANNE GAVIN (APRN, CNP)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:GAVIN
Last Name:BERGLUND
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:GAVIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, CNP
Mailing Address - Street 1:3366 OAKDALE AVE N STE 401
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2986
Mailing Address - Country:US
Mailing Address - Phone:763-520-2940
Mailing Address - Fax:
Practice Address - Street 1:3366 OAKDALE AVE N STE 401
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2986
Practice Address - Country:US
Practice Address - Phone:763-520-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6274363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care