Individual provider · NPI-1

Phyllis Estes Bergman, NP

Nurse Practitioner, Obstetrics & Gynecology · Albuquerque, NM

NPI number1679865844
StatusActive
Last updated in NPPESMay 6, 2011

Details

NPI
1679865844
Entity type
Individual (NPI-1)
Name
Phyllis Estes Bergman
Credential
NP
Sex
Female
Sole proprietor
Yes
Enumeration date
May 6, 2011
Last updated
May 6, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LX0001X Nurse Practitioner, Obstetrics & GynecologyCNP 00742NMYes

Practice location

2207 San Pedro Dr Ne
Albuquerque, NM 87110-4117

Phone 505-281-6131

Mailing address

Po Box 64
Cedar Crest, NM 87008-0064

Phone 505-281-6131

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