Individual
MS. JESSICA ANN BERTALAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8005
(616) 840-9642
Mailing address
PO BOX 1847, MUSKEGON, MI 49443-1847
(231) 727-4444
(231) 728-4789
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601005126
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MI1763010
MEDICARE
MI
Enumeration date
09/20/2007
Last updated
03/31/2021
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