MEDICARE: MS. BERNADETTE JOY MEDINA APRN, FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP2300X	Primary Care Nurse Practitioner	APRN.CNP.0029959	OH
2	363LF0000X	Family Nurse Practitioner	APRN.CNP.0029959	OH

General Provider Information

NPI Number	:	1376201020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BERNADETTE JOY MEDINA APRN, FNP-C

Provider Business Mailing Address
First Line	:	7632 VINNEDGE RD
Second Line	:
City	:	FAIRFIELD TOWNSHIP
State	:	OH
Zip	:	45011-8613
Country	:	US
Telephone Number	:	513-571-9719
Fax Number	:

Provider Business Practice Location Address
First Line	:	1010 CEREAL AVE STE 207
Second Line	:
City	:	HAMILTON
State	:	OH
Zip	:	45013-2772
Country	:	US
Telephone Number	:	513-867-3331
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2021
Last Update Date	:	03/31/2025

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