Provider Demographics
NPI:1194279315
Name:BERTRAND, EMILY G (CRNP)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:G
Last Name:BERTRAND
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:EMILY
Other - Middle Name:G
Other - Last Name:RUSSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:5215 LOUGHBORO RD NW STE 140
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2622
Mailing Address - Country:US
Mailing Address - Phone:202-244-4550
Mailing Address - Fax:202-244-3198
Practice Address - Street 1:5215 LOUGHBORO RD NW STE 140
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2622
Practice Address - Country:US
Practice Address - Phone:202-244-4550
Practice Address - Fax:202-244-3198
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX770759363LF0000X
DCRN1017347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily