| Doctor Name: | ROSE BERGQUIST |
| NPI Number: | 1952401200 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | PAC0235 |
| Business Practice Address: | 1000 Highway 12 Hettinger, ND - 586397530 |
| Business Phone Number: | 7015674561 |
| Business Fax Number: | 7015676361 |
| Mailing Address: | 1000 Highway 12, HETTINGER |
| State: | ND |
| Postal Code: | 586397530 |
| Phone Number: | 7015674561 |
| Fax Number: | 7015676361 |
| NPI Enumeration Date: | 09/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PAC0235 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ND |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |