National Provider Identifier

Tina Marie Bernard, LPN

Tina Marie Bernard, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Newark, NY and a listed phone number of (315) 332-8616.

NPI 1750953998Newark, NYLicensed Practical Nurse

Profile Overview

NPI
1750953998
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
July 16, 2021
Last Updated
July 16, 2021

Practice Location

  • 101 Cobblestone Terrace
  • Newark, NY 14513

Phone: (315) 332-8616

Mailing Address

  • 6009 Boyd Road Lot 36
  • P.O. Box 280
  • Sodus, NY 14551

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1750953998
Entity Type
Individual
Last Name
Bernard
First Name
Tina
Middle Name
Marie
Credential
LPN
Provider Other Last Name
Henry
Provider Other First Name
Tina
Provider Other Middle Name
Marie
Provider Other Credential Text
LPN
Provider Other Last Name Type Code
1
Mailing Street Address
6009 Boyd Road Lot 36
Mailing Address Line 2
P.O. Box 280
Mailing City
Sodus
Mailing State
NY
Mailing ZIP Code
14551
Mailing Country
US
Mailing Phone
(315) 359-1976
Practice Street Address
101 Cobblestone Terrace
Practice City
Newark
Practice State
NY
Practice ZIP Code
14513
Practice Country
US
Practice Phone
(315) 332-8616
Enumeration Date
July 16, 2021
Last Updated
July 16, 2021
Sex
Female
Sole Proprietor
Yes
Certification Date
July 16, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)