Provider Demographics
NPI:1942819131
Name:BERNARD, ALISHA (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ALISHA
Middle Name:
Last Name:BERNARD
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2469 TOPSY RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70611-5724
Mailing Address - Country:US
Mailing Address - Phone:337-377-8337
Mailing Address - Fax:
Practice Address - Street 1:2469 TOPSY RD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70611-5724
Practice Address - Country:US
Practice Address - Phone:337-377-8337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-24
Last Update Date:2020-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA212318363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily