Provider Demographics
NPI:1104146281
Name:BERGMANN, MARY CARDARELLI (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:CARDARELLI
Last Name:BERGMANN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5122 BRADLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-6526
Mailing Address - Country:US
Mailing Address - Phone:301-652-5739
Mailing Address - Fax:
Practice Address - Street 1:THE JOHNS HOPKINS HOSPITAL 600 N WOLFE ST
Practice Address - Street 2:ADMINISTRATION 204
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0001
Practice Address - Country:US
Practice Address - Phone:301-652-5739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR185318363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care