Provider Demographics
NPI:1245482637
Name:BERNARD, KATHRYN ELIZABETH (RN)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:BERNARD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:KATHRYN
Other - Middle Name:WESTON
Other - Last Name:BERNARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:401 HOWARD
Mailing Address - Street 2:HOPE NETWORK BEHAVIORAL HEALTH SERVICES-HOWARD CRISIS
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001
Mailing Address - Country:US
Mailing Address - Phone:269-383-9055
Mailing Address - Fax:264-383-9108
Practice Address - Street 1:401 HOWARD
Practice Address - Street 2:HOPE NETWORK BEHAVIORAL HEALTH SERVICES-HOWARD CRISIS
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001
Practice Address - Country:US
Practice Address - Phone:269-383-9055
Practice Address - Fax:264-383-9108
Is Sole Proprietor?:No
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIID4704148685163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse