Provider Demographics
NPI:1619259959
Name:BERNARDUCCI, BREANNA RACHELLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BREANNA
Middle Name:RACHELLE
Last Name:BERNARDUCCI
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:BREANNA
Other - Middle Name:RACHELLE
Other - Last Name:HIRVONEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:735 MCMILLAN RD
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29634-0001
Mailing Address - Country:US
Mailing Address - Phone:864-656-3562
Mailing Address - Fax:
Practice Address - Street 1:735 MCMILLAN RD
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29634-5400
Practice Address - Country:US
Practice Address - Phone:864-656-0692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36159183500000X
AZS018628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist