Provider Demographics
NPI:1376036087
Name:BERNIER, EMMA (LPN)
Entity Type:Individual
Prefix:MS
First Name:EMMA
Middle Name:
Last Name:BERNIER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WINNIFRED RD
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-4135
Mailing Address - Country:US
Mailing Address - Phone:508-596-7269
Mailing Address - Fax:508-596-7269
Practice Address - Street 1:15 WINNIFRED RD
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-4135
Practice Address - Country:US
Practice Address - Phone:508-596-7269
Practice Address - Fax:508-596-7269
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN66386164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse