| Doctor Name: | ANDREA BERGSTROM |
| NPI Number: | 1013179217 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NP |
| License Number: | R132596-2 |
| Business Practice Address: | 6845 Lee Ave N - Mail Stop 31400a Healthpartners Brooklyn Center Clinic Brooklyn Center, MN - 554291717 |
| Business Phone Number: | 7635690300 |
| Business Fax Number: | 7635690311 |
| Mailing Address: | 8170 33rd Ave S, Ms21110q MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554254516 |
| Phone Number: | 9528835375 |
| Fax Number: | 7635690311 |
| NPI Enumeration Date: | 06/28/2008 |
| NPI Last Update Date: | 12/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | R132596-2 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |