Healthcare Provider Details

I. General information

NPI: 1013316975
Provider Name (Legal Business Name): JAMES G BARTRUM LPN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2014
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3049 N HANOVER AVE
FRESNO CA
93722-8010
US

IV. Provider business mailing address

3049 N HANOVER AVE
FRESNO CA
93722-8010
US

V. Phone/Fax

Practice location:
  • Phone: 559-840-7679
  • Fax:
Mailing address:
  • Phone: 559-840-7679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN289704
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: