Provider Demographics
NPI:1326585910
Name:AKPENGBE, BERNADETTE NKECHI (FNP)
Entity Type:Individual
Prefix:MRS
First Name:BERNADETTE
Middle Name:NKECHI
Last Name:AKPENGBE
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 1:4990 ARLINGTON AVE STE D
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-2757
Mailing Address - Country:US
Mailing Address - Phone:951-785-9011
Mailing Address - Fax:951-785-1436
Practice Address - Street 1:255 N D ST STE 400
Practice Address - Street 2:
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92401-1715
Practice Address - Country:US
Practice Address - Phone:909-455-7571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-20
Last Update Date:2023-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005911363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily