Bertha Ann Clem, RN
Individual provider Active NPI Pediatric Registered Nurse · Chinle, AZ
NPI 1164736732 · NPPES record last updated Dec 30, 2011
Key facts
- NPI
- 1164736732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Registered Nurse 163WP0200X
- License
- RN128530 (AZ)
- Practice address
- Highway 191 & Hospital Road
Chinle, AZ 86503 - Phone
- (928) 674-7166
- Fax
- (928) 674-7705
- NPI assigned
- Aug 5, 2010
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| RN128530 | AZ | MD | Pediatric Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | RN128530 | AZ | Yes |
Addresses
Primary practice location
Highway 191 & Hospital Road
Chinle, AZ 86503
Mailing address
PO Box PH
Chinle, AZ 86503-8000
Phone (928) 674-7166
Other providers in Chinle, AZ
- Chinle Outpatient Treatment Center
- Chinle Unified School District No. 24
- Chang S. Choi
- Tomraj Chorath
- Laura M. Christrup
- Carolyn Diane Click
- Veronica Cloonan
- Catlin Cly
- Raquel Marie Collins
- Stephen Coniaris
All providers in Chinle, AZ · Pediatric Registered Nurse in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.