Breanne Bergeon, FNP-BC
Nurse Practitioner, Family in Live Oak, TX. Individual provider (NPI-1).
NPI number1669358933
StatusActive
Last updated in NPPESOct 14, 2025
Details
- NPI
- 1669358933
- Entity type
- Individual (NPI-1)
- Name
- Breanne Bergeon
- Credential
- FNP-BC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Aug 13, 2025
- Certification date
- Oct 14, 2025
- Last updated
- Oct 14, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 1215635 | TX | Yes |
Practice location
12881 N Ih 35Live Oak, TX 78233-2966
Phone 210-742-6555
Mailing address
4510 N Loop 1604 E Apt 2501San Antonio, TX 78247-2246
Phone 419-351-5223
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 31 Family Nurse Practitioner providers in Live Oak · All 835 providers in Live Oak
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