Provider Demographics
NPI:1487035531
Name:BERGERON, BRITTNEY L (CNM)
Entity Type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:L
Last Name:BERGERON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:
Other - Last Name:MCMAHON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:4 KENT ST
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03087-1645
Mailing Address - Country:US
Mailing Address - Phone:603-401-4739
Mailing Address - Fax:
Practice Address - Street 1:168 KINSLEY ST STE 20
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3634
Practice Address - Country:US
Practice Address - Phone:603-883-3365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2280532367A00000X
NH064637-23367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife