Individual
BARBARA BERTRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 MEDICAL DR, WENTZVILLE, MO 63385-3421
(636) 327-1362
Mailing address
1324 MISSOURI AVE, KIRKWOOD, MO 63122-1018
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
053636
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
918804204
—
MO
01
—
P00281582
RR MEDICARE
MO
Enumeration date
06/22/2005
Last updated
05/02/2008
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