| Doctor Name: | BEVERLY JEAN BERGUM |
| NPI Number: | 1043442304 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | R88457-2 |
| Business Practice Address: | 812 4th Ave Sw Perham, MN - 565731632 |
| Business Phone Number: | 2183463266 |
| Business Fax Number: | |
| Mailing Address: | 812 4th Ave Sw, PERHAM |
| State: | MN |
| Postal Code: | 565731632 |
| Phone Number: | 2183463266 |
| Fax Number: | |
| NPI Enumeration Date: | 08/19/2009 |
| NPI Last Update Date: | 08/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | R88457-2 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |