Individual
MS. BERNADETTE A FETROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 782-5118
(717) 782-5854
Mailing address
409 S 2ND ST, SUITE 2F, HARRISBURG, PA 17104-1612
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN275980L
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN-275980-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007534527
—
PA
01
—
1436948
BLUE SHIELD
—
Enumeration date
10/16/2006
Last updated
12/19/2020
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