Healthcare Provider Details

I. General information

NPI: 1194360354
Provider Name (Legal Business Name): COURTNEY BERNARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5606 PGA BLVD
PALM BEACH GARDENS FL
33418-4122
US

IV. Provider business mailing address

5606 PGA BLVD
PALM BEACH GARDENS FL
33418-4122
US

V. Phone/Fax

Practice location:
  • Phone: 561-789-6427
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11004964
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: