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General NPI Number Information
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NPI Number | 1457699498
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Entity Type | Individual
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Provider Name | DANIELLE MARIE BERTRAM APRN
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Gender | Female
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Dates
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Enumeration Date | 01/25/2013
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Last Update Date | 12/05/2017
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Provider Practice Location Address
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Address Line | 305 W MERCURY ST STE 403
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City | BUTTE
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State | MT
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Zip | 59701-1659
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Country | US
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Telephone | 406-491-6343
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Fax | 406-723-5345
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Provider Business Mailing Address
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Address Line | 98 BURNING TREE LN
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City | BUTTE
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State | MT
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Zip | 59701-3904
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Country | US
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Telephone | 406-491-6343
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1631449
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 364SP0810X
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Taxonomy Name | Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | NUR-RN-LIC-67646
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0991635
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License Number State | CO
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