Provider Demographics
NPI:1285640474
Name:BERNHARDT, CHERYL ANN (NP)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:ANN
Last Name:BERNHARDT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:ANN
Other - Last Name:MACDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:435 NORTH SHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64151-1439
Mailing Address - Country:US
Mailing Address - Phone:816-260-1521
Mailing Address - Fax:
Practice Address - Street 1:435 NW NORTH SHORE DR
Practice Address - Street 2:
Practice Address - City:LAKE WAUKOMIS
Practice Address - State:MO
Practice Address - Zip Code:64151-1453
Practice Address - Country:US
Practice Address - Phone:816-260-1521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO086183363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily