MRS. WENDY L BERTRAM (NPI# 1245341692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245341692 |
| Entity Type | Individual |
| Full Name | MRS. WENDY L BERTRAM |
| Credential | APRN, FNP-BC |
| Practice Address |
2620 N. Russell Long Blvd Canyon TX 79016-0001 |
| Practice Telephone | 8066513287 |
| Practice Fax Number | 8066513289 |
| Mailing Telephone | 8066513287 |
| Mailing Fax Number | 8066513289 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2017-05-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
241305 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | TX APN # 118004 AND TX NURSING LICENSE 241305 | 1245341692 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700410578 | Wendy M Bertram | Social Worker | 19631 W Lincoln St, Buckeye, AZ 85326-8186 | 2020-03-02 |
| Street Address |
2620 N. RUSSELL LONG BLVD |
| City | CANYON |
| State | TX |
| Zip Code | 79016-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912920844 | Candy C Marshall | Nurse Practitioner | 2620 Russell Long Blvd, Canyon, TX 79016 | 2006-07-25 |
| 1811400666 | Tracey Dianne Ecklund | Student in an Organized Health Care Education/Training Program | 2620 Russel Long Blvd, Canyon, TX 79016-0001 | 2017-11-14 |
| 1689014326 | Lorna Strong | Specialist/Technologist | 2342 Russell Long Blvd, Virgil Henson Activities Center 217, Canyon, TX 79016-0001 | 2013-06-26 |
| 1235387184 | Traci B Fredman | Speech-Language Pathologist | 2501 4th Ave, Canyon, TX 79016-0001 | 2008-09-04 |
| 1790971224 | Sally Lynn Gaines | Student in an Organized Health Care Education/Training Program | West Texas A & M University, Old Main, Room 308-a, Canyon, TX 79016-0001 | 2007-09-19 |
| 1639394984 | Robby Douglas Rhodes | Specialist/Technologist | 60216 Wtamu, Canyon, TX 79016-0001 | 2007-04-13 |
| 1992869929 | James Edward Gibbs | Family Medicine | Student Medical Services, 2620 Russell Long Blvd., Canyon, TX 79016-0001 | 2006-12-21 |
| 1407967599 | West Texas A&m University Student Medical Services | Clinic/Center | 2620 N Russel Long Blvd, Virgil Henson Activities Center Room 104, Canyon, TX 79016-0001 | 2006-08-31 |
| 1376526129 | Karen Elizabeth Knapp | Nurse Practitioner | Wt Box 61401, Canyon, TX 79016-0001 | 2005-11-25 |
| 1912410762 | Heather Ann Ferrell | Specialist/Technologist | 2620 Russel Long Blvd, Canyon, TX 79016-0001 | 2017-11-14 |
| Find all providers in zip 79016 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104431238 | Candice Martin Taylor | Nurse Practitioner | 4 Neely Ln, Canyon, TX 79015-6470 | 2020-09-15 |
| 1215433941 | Teresa Diane Smoot | Nurse Practitioner | 2403 Russell Long Blvd, Canyon, TX 79016-0005 | 2018-04-02 |
| 1730454240 | Stephanie Suzanne Macklin | Nurse Practitioner | 1101 4th Ave, Canyon, TX 79015-3701 | 2012-03-16 |
| 1245460625 | Gloria Lewis | Nurse Practitioner | 1619 4th Ave, Canyon, TX 79015 | 2009-07-21 |
| 1376526129 | Karen Elizabeth Knapp | Nurse Practitioner | Wt Box 61401, Canyon, TX 79016-0001 | 2005-11-25 |
| 1043820830 | James Rosson | Nurse Practitioner | 1619 4th Ave, Canyon, TX 79015-3824 | 2020-08-05 |
| 1689283293 | April Oliver | Nurse Practitioner | 911 23rd St, Canyon, TX 79015-4645 | 2020-07-29 |
| 1962010892 | Sarah Elizabeth Carlisle | Nurse Practitioner | 1619 4th Ave, Canyon, TX 79015-3824 | 2020-07-16 |
| 1710534607 | Kaitlyn Wynne | Nurse Practitioner | 301 N 23rd St Ste C, Canyon, TX 79015-3058 | 2019-08-25 |
| 1467964148 | Jennifer Susan Turner | Nurse Practitioner | 911 23rd St, Canyon, TX 79015-4645 | 2017-11-02 |
| Find all providers in CANYON | ||||
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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.