MEDICARE: SHANIA M BERNARD

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	372500000X	Chore Provider
2	372600000X	Adult Companion
3	376J00000X	Homemaker
4	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1740837699
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANIA M BERNARD

Provider Business Mailing Address
First Line	:	1915 SIMMONS ST APT 1066
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1552
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1915 SIMMONS ST APT 1066
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-1552
Country	:	US
Telephone Number	:	702-238-5804
Fax Number	:

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

Provider Enumeration Date	:	08/23/2019
Last Update Date	:	08/23/2019

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Directions to “ SHANIA M BERNARD ” Practice Location

Language	Start Address	Practice Location

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