Individual
BARRY LEE BERTOLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
618 NORTH MORGAN STREET, SHELBY, NC 28150-4439
(704) 480-1882
(704) 480-1832
Mailing address
PO BOX 1418, SHELBY, NC 28151-1418
(704) 480-1882
(704) 480-1832
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
201451
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
201451
NC
363LP2300X
Primary Care Nurse Practitioner
201451
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6605025
—
NC
05
—
89014FP
—
NC
Enumeration date
08/22/2005
Last updated
06/26/2009
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