Individual
KIMBERLY JOHNS BERTUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1802 YAKIMA AVE STE 302, TACOMA, WA 98405-5305
(253) 627-1244
(253) 627-6576
Mailing address
1802 YAKIMA AVE STE 302, TACOMA, WA 98405-5305
(253) 627-1244
(253) 627-6576
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP61550203
WA
363LF0000X
Family Nurse Practitioner
AP09547
LA
363LF0000X
Family Nurse Practitioner
AP61550203
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2289912
—
WA
05
—
2458370
—
LA
Enumeration date
09/28/2017
Last updated
09/27/2024
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