Provider Demographics
NPI:1639945272
Name:NAMATOVU, BERNADETTE CARMEL (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:CARMEL
Last Name:NAMATOVU
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4609 W SHORE DR
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-3783
Mailing Address - Country:US
Mailing Address - Phone:815-670-8265
Mailing Address - Fax:
Practice Address - Street 1:4609 W SHORE DR
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-3783
Practice Address - Country:US
Practice Address - Phone:815-670-8265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209029229363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health