Provider Demographics
NPI:1225316730
Name:BERTOLAMI, ASHLEY R (RN, MSN, AGNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:R
Last Name:BERTOLAMI
Suffix:
Gender:F
Credentials:RN, MSN, AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:280 MAIN ST STE 210A
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-2920
Mailing Address - Country:US
Mailing Address - Phone:603-577-3080
Mailing Address - Fax:603-577-3081
Practice Address - Street 1:280 MAIN ST STE 210A
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-2920
Practice Address - Country:US
Practice Address - Phone:603-577-3080
Practice Address - Fax:603-577-3081
Is Sole Proprietor?:No
Enumeration Date:2011-08-01
Last Update Date:2014-05-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH062930-23363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology