Provider Demographics
NPI:1568754307
Name:BERNARD, STEPHANIE (PA-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:BERNARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:918 BERKSHIRE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15226-2140
Mailing Address - Country:US
Mailing Address - Phone:412-519-2728
Mailing Address - Fax:
Practice Address - Street 1:460 WASHINGTON RD
Practice Address - Street 2:SUITE 7
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-2765
Practice Address - Country:US
Practice Address - Phone:724-225-3627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054615363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant