Provider Demographics
NPI:1598876690
Name:MAYER, BERNA LEE (RN, MSN, CFNP)
Entity Type:Individual
Prefix:MS
First Name:BERNA
Middle Name:LEE
Last Name:MAYER
Suffix:
Gender:F
Credentials:RN, MSN, CFNP
Other - Prefix:
Other - First Name:BERNA
Other - Middle Name:
Other - Last Name:BACCHUS & SHERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7007
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-7007
Mailing Address - Country:US
Mailing Address - Phone:661-945-5984
Mailing Address - Fax:661-726-3890
Practice Address - Street 1:43839 15TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-4756
Practice Address - Country:US
Practice Address - Phone:661-945-5984
Practice Address - Fax:661-726-3890
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN 375729163W00000X
CANP 4699363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care