Provider Demographics
NPI:1740010818
Name:BERGERON, ERIN M (RN)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:BERGERON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:M
Other - Last Name:DREW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:22 VIRGINIA LN
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-1241
Mailing Address - Country:US
Mailing Address - Phone:860-305-9223
Mailing Address - Fax:
Practice Address - Street 1:441 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2576
Practice Address - Country:US
Practice Address - Phone:413-585-8631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2281386163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse