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Contact Information

DAVID N BERGTHOLD, MSN-ACNP
54 HOSPITAL DR
OSAGE BEACH, MO65065-3050
 Phone: 573-302-2287
 Fax: 573-302-2241
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acute Care

363LA2100X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for DAVID N BERGTHOLD · (Male)

NPI # 1336331065
Status Active
Credentials MSN-ACNP
Entity Individual
Enumeration date 08/16/2007
Last updated 12/07/2012 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 139652
  • MO Medicaid 1336331065
  • MO Other 135570015 MEDICARE PTAN
  • MO Other P00750268 RAIL ROAD MEDICARE
Hospital affiliation(s)
  • LAKE REGIONAL HEALTH SYSTEM - (Acute Care)
    54 HOSPITAL DRIVE
    OSAGE BEACH, MO 65065
  • MERCY HOSPITAL SPRINGFIELD - (Acute Care)
    1235 E CHEROKEE
    SPRINGFIELD, MO 65804
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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