Provider Demographics
NPI:1588004956
Name:BERTHIAUME, BARBARA K (RN)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:K
Last Name:BERTHIAUME
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:K
Other - Last Name:EBERHART
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:5538 CHRISTYWAY CT
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-3104
Mailing Address - Country:US
Mailing Address - Phone:989-338-3829
Mailing Address - Fax:
Practice Address - Street 1:5538 CHRISTYWAY CT
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-3104
Practice Address - Country:US
Practice Address - Phone:989-338-3829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-01
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704229847163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health