Healthcare Provider Details

I. General information

NPI: 1205744653
Provider Name (Legal Business Name): OLIVIA ROSE BERNARD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 E OSBORN RD
SCOTTSDALE AZ
85251-6432
US

IV. Provider business mailing address

934 S ASH ST
GILBERT AZ
85233-7733
US

V. Phone/Fax

Practice location:
  • Phone: 480-583-0501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number228882
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: