Provider Demographics
NPI:1447403050
Name:FLOWE, BERNADETTE LEILANI SIMON (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:BERNADETTE
Middle Name:LEILANI SIMON
Last Name:FLOWE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 16TH ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92648-4013
Mailing Address - Country:US
Mailing Address - Phone:805-850-9542
Mailing Address - Fax:714-465-2035
Practice Address - Street 1:503 16TH ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-4013
Practice Address - Country:US
Practice Address - Phone:805-850-9547
Practice Address - Fax:714-465-2035
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANA3769367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered