Shelly Bertram, R.N.

Individual provider Active NPI School Registered Nurse · Tolleson, AZ

NPI 1003284027 · NPPES record last updated Sep 8, 2015

Key facts

NPI
1003284027
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
RN097015 (AZ)
Practice address
9261 W Van Buren St
Tolleson, AZ 85353-2941
Phone
(623) 936-9740
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN097015AZMDSchool Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X RN097015 AZ Yes

Addresses

Primary practice location

9261 W Van Buren St
Tolleson, AZ 85353-2941

Mailing address

9261 W Van Buren St
Tolleson, AZ 85353-2941
Phone (623) 936-9740

Other providers in Tolleson, AZ

All providers in Tolleson, AZ · School Registered Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.