Provider Demographics
NPI:1508661083
Name:BERNARDO, GARY CHRISTOPHER (CNP)
Entity type:Individual
Prefix:MR
First Name:GARY
Middle Name:CHRISTOPHER
Last Name:BERNARDO
Suffix:
Gender:
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38401 MENTOR AVE UNIT 8209
Mailing Address - Street 2:
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-8766
Mailing Address - Country:US
Mailing Address - Phone:330-283-6394
Mailing Address - Fax:
Practice Address - Street 1:38401 MENTOR AVE UNIT 8209
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-8766
Practice Address - Country:US
Practice Address - Phone:330-283-6394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAG09240049363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care