Provider Demographics
NPI:1811167521
Name:BERNARD, CHRISTINA (CFTS)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:BERNARD
Suffix:
Gender:F
Credentials:CFTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W NC HIGHWAY 54
Mailing Address - Street 2:STE 267
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-6646
Mailing Address - Country:US
Mailing Address - Phone:919-852-0052
Mailing Address - Fax:800-311-7783
Practice Address - Street 1:105 W NC HIGHWAY 54
Practice Address - Street 2:STE 267
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6646
Practice Address - Country:US
Practice Address - Phone:919-852-0052
Practice Address - Fax:800-311-7783
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCFTS0353247200000X
NCC46780246Z00000X, 225000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic Fitter
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
No246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1619935913OtherADVANCED HOME CARE INC; EMPLOYER