Provider Demographics
NPI:1881672996
Name:BERNARD, KARI SUE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:SUE
Last Name:BERNARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MRS
Other - First Name:KARI
Other - Middle Name:BERNARD
Other - Last Name:SHMUL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3211 PROVIDENCE DR
Mailing Address - Street 2:BRAGAW OFFICE BUILDING SUITE 220
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4614
Mailing Address - Country:US
Mailing Address - Phone:907-786-5481
Mailing Address - Fax:
Practice Address - Street 1:4315 DIPLOMACY DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-5926
Practice Address - Country:US
Practice Address - Phone:907-729-1729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1147363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical