Healthcare Provider Details

I. General information

NPI: 1245125657
Provider Name (Legal Business Name): BERTRAM HENRY MSN, APRN, FNP-BC,
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 CARE WAY
FREDERICKSBURG VA
22401-8425
US

IV. Provider business mailing address

1051 CARE WAY
FREDERICKSBURG VA
22401-8425
US

V. Phone/Fax

Practice location:
  • Phone: 540-374-3131
  • Fax: 540-374-3134
Mailing address:
  • Phone: 540-374-3131
  • Fax: 540-374-3134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11039952
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: