Provider Demographics
NPI:1790868883
Name:BERNARD, JANET ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:ELIZABETH
Last Name:BERNARD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N BAILEY AVE
Mailing Address - Street 2:P.O. BOX 1208
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5436
Mailing Address - Country:US
Mailing Address - Phone:308-534-0440
Mailing Address - Fax:308-534-7675
Practice Address - Street 1:110 N BAILEY AVE
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5436
Practice Address - Country:US
Practice Address - Phone:308-534-0440
Practice Address - Fax:308-534-7675
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE16458207Q00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47081633613Medicaid
NE47081633613Medicaid
NE271217BEMedicare ID - Type Unspecified