Provider Demographics
NPI:1326317165
Name:BERTRAM, KAREN MARIE (RN)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:BERTRAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8372 COUNTY ROUTE 75
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13611-0158
Mailing Address - Country:US
Mailing Address - Phone:315-846-5323
Mailing Address - Fax:315-846-5617
Practice Address - Street 1:8372 COUNTY ROUTE 75
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13611-0158
Practice Address - Country:US
Practice Address - Phone:315-846-5323
Practice Address - Fax:315-846-5617
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-23
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277990163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool