Provider Demographics
NPI:1013407162
Name:BERNSTINE, TARYONE ELAINE (FNP)
Entity Type:Individual
Prefix:
First Name:TARYONE
Middle Name:ELAINE
Last Name:BERNSTINE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 N MERIDIAN GREENS DR
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-8369
Mailing Address - Country:US
Mailing Address - Phone:832-738-0279
Mailing Address - Fax:
Practice Address - Street 1:1728 N MERIDIAN GREENS DR
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-8369
Practice Address - Country:US
Practice Address - Phone:832-738-0279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-15
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily