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Individual

MR. NORMAN LEO BERTHIAUME

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-C

Contact information

Practice address
1200 ROBERTS AVE NE, COOPERSTOWN, ND 58425-7101
(701) 797-2221
(701) 797-2457
Mailing address
1200 ROBERTS AVE NE, COOPERSTOWN, ND 58425-7101
(701) 797-2221
(701) 797-2457

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R015780
ME
363LP2300X
Primary Care Nurse Practitioner
Primary
R34592
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
128170099
ME
Enumeration date
08/29/2006
Last updated
10/07/2009
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