Basic Information
| Provider Information | |||||||||
| NPI: | 1992800015 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEBLANC | ||||||||
| FirstName: | YVONNE | ||||||||
| MiddleName: | BERGERON | ||||||||
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| Credential: | RN, CNOR, CRNFA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 79 PHILLIP ST | ||||||||
| Address2: | |||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031022358 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036241475 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 100 MCGREGOR ST | ||||||||
| Address2: | CATHOLIC MEDICAL CENTER | ||||||||
| City: | MANCHESTER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 031023730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6036683545 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SP2800X | 016157-21 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Perioperative |
No ID Information.