Provider Demographics
NPI:1568034429
Name:BERNS, RICARDO LAWRENCE
Entity Type:Individual
Prefix:
First Name:RICARDO
Middle Name:LAWRENCE
Last Name:BERNS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 LAKEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-1882
Mailing Address - Country:US
Mailing Address - Phone:513-716-2839
Mailing Address - Fax:
Practice Address - Street 1:6 LAKEFIELD DR
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1882
Practice Address - Country:US
Practice Address - Phone:513-716-2839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-12
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH443272163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse