Bergstrom, Jordan Leigh

Bergstrom, Jordan Leigh is an individual health care provider with primary practice located at 1753 Fulton St , Elkhart IN 46514-1927. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Bergstrom, Jordan Leigh can be contacted via phone (574) 293-9448.

Contact Information

Primary practice address
1753 Fulton St Elkhart IN 46514-1927
Phone: (574) 293-9448
Fax: (574) 293-9480
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 23002688A Indiana

Profile Details

NPI number 1750941779
LBN Legal business name Bergstrom, Jordan Leigh
Credentials AU.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2019
Last updated Mar 30th, 2021 - about 4 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 1750941779 NPPES
Indiana MEDICAID 300027641

Popular Providers