Bergeron, Dawn Elizabeth

Bergeron, Dawn Elizabeth is an sole proprietor health care provider with primary practice located at 2901 Lone Oak Rd , Bloomington IL 61705-7802. She recently has only one registered license in Nursing Service Related Providers / Religious Nonmedical Practitioner, which is considered as her primary health care specialty. Bergeron, Dawn Elizabeth can be contacted via phone (309) 846-0899.

Contact Information

Primary practice address
2901 Lone Oak Rd Bloomington IL 61705-7802
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Religious Nonmedical Practitioner 374K00000X 171400000X Illinois

Profile Details

NPI number 1851091417
LBN Legal business name Bergeron, Dawn Elizabeth
Credentials FMCHC AND IHP2
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 3rd, 2023
Last updated Mar 3rd, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1851091417 NPPES
Other 171400000X GENERAL

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