Provider / Organization | NPI | Date Certified |
---|---|---|
NANCY BERGQUIST | 1336290683 | 2024-07-05 |
Nancy Bergquist is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1336290683. Registration indicates Nancy Bergquist is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Family Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians)
Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
Entity Type | Individual |
Provider Name | Nancy Bergquist MD, DC |
Other Provider Name | Nancy Weidner |
Practice Office Address | 2360 E PERSHING BLVD CHEYENNE, WY US |
Practice Office Telephone | 3077787550 |
Mailing Address | 1740 DELL RANGE BLVD # H291 CHEYENNE, WY 820094961 US |
Business Telephone | 7193578980 |
CRMC Direct Address [] | [email protected] | Direct Memorial Hospital of Laramie County |
CRMC Direct Address [] | [email protected] | Health Information Exchange (HIE) Memorial Hospital of Laramie County |
Code | Practice | License No State |
---|---|---|
207Q00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | 13810A
WY |