Bergholm, Brenda

Bergholm, Brenda is an individual health care provider with primary practice located at 300 S 3Rd W , Soda Springs ID 83276-1559. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Bergholm, Brenda can be contacted via phone (208) 547-3341.

Contact Information

Primary practice address
300 S 3Rd W Soda Springs ID 83276-1559
Phone: (208) 547-3341
Fax: (208) 547-2790
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 364SA2200X CNS-47A Idaho

Profile Details

NPI number 1548493521
LBN Legal business name Bergholm, Brenda
Credentials MSN, ACNS-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2009
Last updated Aug 25th, 2009 - about 16 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1548493521 NPPES
Idaho Other CNS-47A IDAHO STATE LICENSE

Popular Providers