Provider Demographics
NPI:1164968129
Name:BERNDSEN, JEAN A (RN)
Entity Type:Individual
Prefix:MRS
First Name:JEAN
Middle Name:A
Last Name:BERNDSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7105 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236-3338
Mailing Address - Country:US
Mailing Address - Phone:513-250-6464
Mailing Address - Fax:
Practice Address - Street 1:4380 MALSBARY RD
Practice Address - Street 2:
Practice Address - City:BLUE ASH
Practice Address - State:OH
Practice Address - Zip Code:45242-5644
Practice Address - Country:US
Practice Address - Phone:513-793-6444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.166609163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool