Bergman, Mary Beth Valek

Bergman, Mary Beth Valek is an sole proprietor health care provider with primary practice located at 14121 Parke Long Ct Suite 201, Chantilly VA 20151-1647. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Bergman, Mary Beth Valek can be contacted via phone (440) 503-8519.

Contact Information

Primary practice address
14121 Parke Long Ct Suite 201 Chantilly VA 20151-1647
Phone: (440) 503-8519
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X APRN.CNP.15082 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X APRN.CNP.15082 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X APRN.CNP.15082 Ohio

Profile Details

NPI number 1184034555
LBN Legal business name Bergman, Mary Beth Valek
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 6th, 2014
Last updated Apr 18th, 2017 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1184034555 NPPES
Ohio MEDICAID 0103279

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