Provider Demographics
NPI:1497171516
Name:BERGE, KELSEY BRIDGEWATER (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:BRIDGEWATER
Last Name:BERGE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15901 EAST BRIARWOOD CIRCLE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016
Mailing Address - Country:US
Mailing Address - Phone:303-269-2626
Mailing Address - Fax:303-269-2620
Practice Address - Street 1:15901 EAST BRIARWOOD CIRCLE
Practice Address - Street 2:SUITE 200
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016
Practice Address - Country:US
Practice Address - Phone:303-269-2626
Practice Address - Fax:303-269-2620
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991052-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner