Provider Demographics
NPI:1558838615
Name:BERTRAND, CHRISTIAN MICHAEL (FNP-C)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:MICHAEL
Last Name:BERTRAND
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 122425 DEPT 2425
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75312-2425
Mailing Address - Country:US
Mailing Address - Phone:337-494-4747
Mailing Address - Fax:337-494-4773
Practice Address - Street 1:2770 3RD AVE STE 110
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-0404
Practice Address - Country:US
Practice Address - Phone:337-494-4747
Practice Address - Fax:337-494-4773
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAAP10095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily