Provider Demographics
NPI:1740585413
Name:BERGERON, EMILY ANN (CD(DONA))
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:ANN
Last Name:BERGERON
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 SONNIER RD
Mailing Address - Street 2:
Mailing Address - City:CARENCRO
Mailing Address - State:LA
Mailing Address - Zip Code:70520-6334
Mailing Address - Country:US
Mailing Address - Phone:337-501-9686
Mailing Address - Fax:
Practice Address - Street 1:211 SONNIER RD
Practice Address - Street 2:
Practice Address - City:CARENCRO
Practice Address - State:LA
Practice Address - Zip Code:70520-6334
Practice Address - Country:US
Practice Address - Phone:337-501-9686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-11
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula