Provider Demographics
NPI:1316595424
Name:BERNAL, NORMA ALICIA (NP)
Entity Type:Individual
Prefix:
First Name:NORMA
Middle Name:ALICIA
Last Name:BERNAL
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:901 MCCLINTOCK DR STE 202
Mailing Address - Street 2:
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60527-0872
Mailing Address - Country:US
Mailing Address - Phone:630-655-6748
Mailing Address - Fax:630-734-4715
Practice Address - Street 1:899 N WILMOT RD STE D6
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1713
Practice Address - Country:US
Practice Address - Phone:877-448-3627
Practice Address - Fax:630-734-4715
Is Sole Proprietor?:No
Enumeration Date:2019-09-01
Last Update Date:2019-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ230405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty