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General NPI Number Information
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NPI Number | 1457297152
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Entity Type | Individual
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Provider Name | SAMANTHA LYNN BERTRAND
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Gender | Female
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Dates
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Enumeration Date | 04/25/2026
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Last Update Date | 04/25/2026
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Provider Practice Location Address
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Address Line | 2478 PATTERSON RD
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City | GRAND JUNCTION
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State | CO
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Zip | 81505-3605
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Country | US
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Telephone | 970-985-4506
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Fax |
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Provider Business Mailing Address
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Address Line | 221 RIBBON CT
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City | FRUITA
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State | CO
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Zip | 81521-2578
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Country | US
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Telephone | 304-280-8849
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APN.1001821
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License Number State | CO
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