Stacee Byrd Bertolla, CRNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-063545 Issued in AL

Practice address

1700 Center St
Mobile, AL 36604-3301

Phone

(251) 415-1144

NPI assigned

Apr 12, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523491200000",
    "number": "1326545575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16513 COUNTY ROAD 68",
            "city": "LOXLEY",
            "state": "AL",
            "postal_code": "365513219",
            "telephone_number": "251-228-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 CENTER ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366043301",
            "telephone_number": "251-415-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERTOLLA",
        "first_name": "STACEE",
        "middle_name": "BYRD",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2018-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-063545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Berry
• Lauren Berry
• Olivia Berry
• Travis Berry, DO
• Alexis Bertolla
• Roxanne Beshear
• Sabrina G. Bessette, M.D.
• Luis Betancourt, M.D
• Adriana Celina Betancourth Alvarenga, MD.
• Vladimer Betchvaia

• All providers in Mobile, AL
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.