Most Relevant Information
Provider Data
| NPI Number: | 1003441239 |
| Provider Name: | VINCENT ANTHONY BERGAMO |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 25881 |
Most Important Dates
| Enumeration Date: | 03/09/2020 |
| Last Updated: | 03/09/2020 |
Provider Practice Location
1861 MAIN ST
SNEEDVILLE
TN
378693645
Practice Location Phone/Fax
| Phone: | 4237332131 |
| Fax: | 4237331055 |
Provider Mailing Location
PO BOX 850
ROGERSVILLE
TN
378570850
Provider Mailing Phone/Fax
| Phone: | 4232729163 |
| Fax: | 4239216920 |