Provider Demographics
NPI:1952092173
Name:BERNARD, TEAREA
Entity Type:Individual
Prefix:MS
First Name:TEAREA
Middle Name:
Last Name:BERNARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MEGAN LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-6002
Mailing Address - Country:US
Mailing Address - Phone:504-261-3981
Mailing Address - Fax:
Practice Address - Street 1:1901 MANHATTAN BLVD BLDG D3622
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-3582
Practice Address - Country:US
Practice Address - Phone:504-261-3981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-18
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy