Provider Demographics
NPI:1811171390
Name:BERGMANN, GABRIELLE SUZANNE (APRN, BC)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:SUZANNE
Last Name:BERGMANN
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIT 31550
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09828
Mailing Address - Country:US
Mailing Address - Phone:24381-556-0151
Mailing Address - Fax:24381-556-0172
Practice Address - Street 1:US EMBASSY KINSHASA
Practice Address - Street 2:310 AVENUE DES AVIATEURS, GOMBE
Practice Address - City:KINSHASA
Practice Address - State:KINSHASA
Practice Address - Zip Code:000
Practice Address - Country:CD
Practice Address - Phone:24381-556-0151
Practice Address - Fax:24381-556-0172
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024166508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily