Individual
SHELLY BERTRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
9261 W VAN BUREN ST, TOLLESON, AZ 85353-2941
(623) 936-9740
Mailing address
9261 W VAN BUREN ST, TOLLESON, AZ 85353-2941
(623) 936-9740
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN097015
AZ
Other
Enumeration date
09/08/2015
Last updated
09/08/2015
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