SHELLY BERTRAM (NPI# 1003284027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003284027 |
| Entity Type | Individual |
| Full Name | SHELLY BERTRAM |
| Credential | R.N. |
| Practice Address |
9261 W Van Buren St Tolleson AZ 85353-2941 |
| Practice Telephone | 6239369740 |
| Mailing Telephone | 6239369740 |
| Enumeration Date | 2015-09-08 |
| Last Update Date | 2015-09-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WS0200X |
Registered Nurse Specialization: School |
RN097015 | AZ | Nursing Service Providers |
| Street Address |
9261 W VAN BUREN ST |
| City | TOLLESON |
| State | AZ |
| Zip Code | 85353-2941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356351415 | Rakeesha R Reeves | Speech-Language Pathologist | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2006-08-09 |
| 1164034344 | Erin Esbenshade | Speech-Language Pathologist | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2020-08-19 |
| 1891079950 | Wendy S Medford | Registered Nurse | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2011-10-06 |
| 1629209671 | Shayna Elizabeth Weir | Specialist | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2009-08-06 |
| 1376793463 | Angela Ann Pawloski | Psychologist | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2008-09-24 |
| 1124284542 | Precious Faith Hasanon Porter | Registered Nurse | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2008-08-05 |
| 1336305085 | Maria A. Conde | Registered Nurse | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2008-08-01 |
| 1124284872 | Rene M. Akande | Registered Nurse | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2008-08-01 |
| 1710153507 | Catherine Irene Turner-raborn | Registered Nurse | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2008-05-01 |
| 1881871648 | Amy Lauren Wilgus | Speech-Language Pathologist | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2008-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710503388 | Annie's Home, LLC | Home Health | 8517 W Chickasaw St., Tolleson, AZ 85353 | 2020-06-19 |
| 1427614429 | Destiny Behavioral Health Residential Care LLC 6 | Community Based Residential Treatment Facility, Mental Illness | 8755 W Pioneer Street, Tolleson, AZ 85353 | 2019-05-15 |
| 1831669258 | New Beginning Behavioral Health LLC | Psychiatric Residential Treatment Facility | 3329 S 87th Dr, Tolleson, AZ 85353 | 2018-11-28 |
| 1679049886 | Jaclyn Peters | Registered Nurse | 9401 West Garfield Street, Tolleson, AZ 85353 | 2018-10-16 |
| 1265949861 | Destiny Behavioral Health Residential Care LLC 5 | Community Based Residential Treatment Facility, Mental Illness | 10313 W Hess Street, Tolleson, AZ 85353 | 2018-01-04 |
| 1174858260 | Earl Dean Elwood | Pharmacist | 500 S. 99th Ave, Tolleson, AZ 85353 | 2009-10-07 |
| 1952533556 | Sun Valley Pharmacy LLC | Pharmacy | 219 W Pima, Gila Bend, AZ 85353 | 2009-08-14 |
| 1467570747 | Union Elementary School | Local Education Agency (LEA) | 3834 S 91st Ave, Tolleson, AZ 85353 | 2007-03-26 |
| 1285798462 | Promenade Dental Group, LLP | Dentist | 2755 S 99th Ave, Ste 105, Tolleson, AZ 85353 | 2006-12-21 |
| 1679636781 | Greta Denise Doss | Respite Care | 3006 S 102 Ln, Tolleson, AZ 85353 | 2006-12-19 |
| Find all providers in zip 85353 | ||||
| Taxonomy Code | 163WS0200X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679049886 | Jaclyn Peters | Registered Nurse | 9401 West Garfield Street, Tolleson, AZ 85353 | 2018-10-16 |
| 1740780394 | Kayla Renee Hyduke | Registered Nurse | 10207 W Country Place Blvd, Tolleson, AZ 85353-8450 | 2018-02-20 |
| 1891079950 | Wendy S Medford | Registered Nurse | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2011-10-06 |
| 1912280975 | Danielle Hughes | Registered Nurse | 9401 W Garfield St, Tolleson, AZ 85353-1606 | 2011-09-26 |
| 1215051495 | Sandra Lorene Caban | Registered Nurse | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2007-03-16 |
| 1609904028 | Chris D. Gunderson | Registered Nurse | 9261 W Van Buren St, Tolleson, AZ 85353-2941 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992318612 | Mary Jane Zdyrski | Registered Nurse | 4455 S Mission Rd, Tucson, AZ 85746-4014 | 2020-08-24 |
| 1740890896 | Olivia Yvette Sandoval | Registered Nurse | 3437 Jamaica Blvd S, Lake Havasu City, AZ 86406-5507 | 2020-08-04 |
| 1336761303 | Daniel James Emborsky Jr. | Registered Nurse | 3550 Prospector St, Kingman, AZ 86401-1900 | 2020-05-13 |
| 1043857097 | Karen M Garcia | Registered Nurse | 2631 N Brown Avenue, Casa Grande, AZ 85122 | 2019-12-09 |
| 1679110894 | Elizabeth Amber Sim | Registered Nurse | 20873 W Sunrise Ln, Buckeye, AZ 85396-7593 | 2019-12-06 |
| 1306482377 | Cecilia Denise Zepeda | Registered Nurse | 1250 N. 8th Avenue, San Luis, AZ 85349 | 2019-11-25 |
| 1366088635 | Jennifer Lynn White | Registered Nurse | 1193 S 16th Pl, Cottonwood, AZ 86326-6939 | 2019-11-21 |
| 1700421112 | Jill Smith | Registered Nurse | 18601 W. Campbell Avenue, Goodyear, AZ 85395-8539 | 2019-11-08 |
| 1780227413 | Gabriela Flores | Registered Nurse | 44150 W. Maricopa Casa Grande Hwy, Maricopa, AZ 85138 | 2019-10-25 |
| 1033752761 | Lizabeth Joy Stephens | Registered Nurse | 44150 West Maricopa-casa Grand Hwy., Maricopa, AZ 85138 | 2019-10-25 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.