Provider Demographics
NPI:1457416497
Name:BERNHARD, AMY K (PA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:BERNHARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3200 BURNET AVE
Mailing Address - Street 2:3 SOUTH CREDENTIALING
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3019
Mailing Address - Country:US
Mailing Address - Phone:513-585-5503
Mailing Address - Fax:513-585-5511
Practice Address - Street 1:7759 UNIVERSITY DRIVE, SUITE C
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2505
Practice Address - Country:US
Practice Address - Phone:513-475-8282
Practice Address - Fax:513-475-8283
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2014-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH50-002548363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant