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Individual

MRS. BOBBIE JO BERTRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CNP

Contact information

Practice address
1406 6TH AVE N, ST. CLOUD HOSPITAL, SAINT CLOUD, MN 56303-1900
(320) 255-5656
(320) 656-7044
Mailing address
1406 6TH AVE N, ST. CLOUD HOSPITAL, SAINT CLOUD, MN 56303-1900
(320) 255-5656
(320) 656-7044

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R-156834-7
MN
363LF0000X
Family Nurse Practitioner
Primary
R156834
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PEND
MN
Enumeration date
06/26/2010
Last updated
02/14/2014
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