Provider Demographics
NPI:1376201020
Name:MEDINA, BERNADETTE JOY (APRN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:JOY
Last Name:MEDINA
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7632 VINNEDGE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-8613
Mailing Address - Country:US
Mailing Address - Phone:513-571-9719
Mailing Address - Fax:
Practice Address - Street 1:1010 CEREAL AVE STE 207
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-2772
Practice Address - Country:US
Practice Address - Phone:513-867-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-30
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0029959363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care