Provider Demographics
NPI:1285225979
Name:BERNARD, LORI ANN (MA)
Entity Type:Individual
Prefix:MISS
First Name:LORI
Middle Name:ANN
Last Name:BERNARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:MONTNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:12907 WOODGROVE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-8861
Mailing Address - Country:US
Mailing Address - Phone:586-277-5667
Mailing Address - Fax:
Practice Address - Street 1:12907 WOODGROVE DR
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-8861
Practice Address - Country:US
Practice Address - Phone:586-277-5667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate