Provider Demographics
NPI:1336250182
Name:BERGERON, RHONDA GERACE (APRN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:GERACE
Last Name:BERGERON
Suffix:
Gender:F
Credentials:APRN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 SAIZAN AVENUE
Mailing Address - Street 2:
Mailing Address - City:PORT BARRE
Mailing Address - State:LA
Mailing Address - Zip Code:70577
Mailing Address - Country:US
Mailing Address - Phone:337-447-4027
Mailing Address - Fax:337-585-2674
Practice Address - Street 1:414 SAIZON AVENUE
Practice Address - Street 2:
Practice Address - City:PORT BARRE
Practice Address - State:LA
Practice Address - Zip Code:70577
Practice Address - Country:US
Practice Address - Phone:337-447-4027
Practice Address - Fax:337-585-2674
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP05015363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily