Provider Demographics
NPI:1578349718
Name:BERTRAND, MELISSA (APRN)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BERTRAND
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 SW 80TH TER APT 125
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-4075
Mailing Address - Country:US
Mailing Address - Phone:954-558-6390
Mailing Address - Fax:
Practice Address - Street 1:11501 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-6507
Practice Address - Country:US
Practice Address - Phone:954-558-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11026590363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care