P Praxis·MD
● Active Type 1 · Individual

Brenda Bergholm, MSN, ACNS-BC

Clinical Nurse Specialist·Soda Springs, ID· NPI 1548493521 · Enumerated 2009 · 16 years on NPI
Bergholm is 1 of 1 clinical nurse specialist providers in Soda Springs and 1 of 15 in Idaho.
NPI age
16 years
Enumerated 2009-08-25
Primary specialty
Clinical Nurse Specialist
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2009-08-25
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 15 active clinical nurse specialist providers in Idaho.

NPI age
16 years
↑ 2 yr above median (14 yr)
State licenses
1 state
6% of peers hold multiple states
Subspecialties
0
26% of peers hold subspecialties

NPI lifetime · 2009 → 2026

2009-08Enumerated in NPPES
2009 2026

Where they practice

Practice location
300 S 3rd W
Soda Springs, ID 832761559
📞 2085473341fax 2085472790
Mailing address
300 S 3rd W
Soda Springs, ID 832761559
📞 2085473341fax 2085472790

Specialties

  • Clinical Nurse Specialist Primary
    Definition to come...
    ID license #CNS-47A taxonomy 364SA2200X

Identifiers

TypeValueNotes
01 (ID) CNS-47A IDAHO STATE LICENSE

Practice context

Part of a multi-provider practice. 23 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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