Bergerud, Heather Marie

Bergerud, Heather Marie is an individual health care provider with primary practice located at 3745 Louisiana Ave S , St. Louis Park MN 55426. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Bergerud, Heather Marie can be contacted via phone (952) 922-4427.

Contact Information

Primary practice address
3745 Louisiana Ave S St. Louis Park MN 55426
Phone: (952) 922-4427
Fax: (952) 922-4761
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2621 Minnesota

Profile Details

NPI number 1669545018
LBN Legal business name Bergerud, Heather Marie
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2006
Last updated Jul 8th, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1669545018 NPPES
Minnesota Other 2201839 MEDICA
Minnesota Other 300J5BE MEDICA

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