Bernadette Marie Gotchie, RN, BSN,PHN,DON

Individual provider Active NPI Registered Nurse · Cass Lake, MN

NPI 1346549862 · NPPES record last updated Mar 23, 2011

Key facts

NPI
1346549862
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R170708-5 (MN)
Practice address
115 6TH St NE
Cass Lake, MN 56633-3428
Phone
(218) 335-4500
Fax
(218) 335-4513
NPI assigned
Mar 23, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
R170708-5MNMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Leech Lake Tribal Council Past
since Sep 6, 2020
Accepting new patients
Leech Lake Tribal Council Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R170708-5 MN Yes

Addresses

Primary practice location

115 6TH St NE
Cass Lake, MN 56633-3428

Mailing address

115 6TH St NE
Cass Lake, MN 56633-3428
Phone (218) 335-4500

Other providers in Cass Lake, MN

All providers in Cass Lake, MN · Registered Nurse in Minnesota

Sources for this page

Verify at the official NPI Registry.