MEDICARE: NADIA J BARTELL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician	RBT-23-258373	NC

General Provider Information

NPI Number	:	1114610060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NADIA J BARTELL

Provider Business Mailing Address
First Line	:	4320 SUGARSTONE LN APT 202
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-3237
Country	:	US
Telephone Number	:	843-229-5707
Fax Number	:

Provider Business Practice Location Address
First Line	:	4320 SUGARSTONE LN APT 202
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-3237
Country	:	US
Telephone Number	:	843-229-5707
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2023
Last Update Date	:	05/29/2023

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