Bergen, Kelly Marie

Bergen, Kelly Marie is an sole proprietor health care provider with primary practice located at 2555 Court Dr Suite 300, Gastonia NC 28054-2134. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Bergen, Kelly Marie can be contacted via phone (704) 868-3256.

Contact Information

Primary practice address
2555 Court Dr Suite 300 Gastonia NC 28054-2134
Phone: (704) 868-3256
Fax: (704) 868-5870
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 162782 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 162782 North Carolina

Profile Details

NPI number 1093183642
LBN Legal business name Bergen, Kelly Marie
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 11th, 2015
Last updated Sep 29th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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