Individual
STACEE BYRD BERTOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1700 CENTER ST, MOBILE, AL 36604-3301
(251) 415-1144
Mailing address
16513 COUNTY ROAD 68, LOXLEY, AL 36551-3219
(251) 228-0080
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-063545
AL
Other
Enumeration date
04/12/2018
Last updated
04/12/2018
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