Healthcare Provider Details

I. General information

NPI: 1922003524
Provider Name (Legal Business Name): BERNADETTE K PRICE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 05/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

297 W FRANCISCAN DR SUITE 203
CROWN POINT IN
46307-4858
US

IV. Provider business mailing address

1040 SIERRA DR SUITE 400
GREENWOOD IN
46143-7241
US

V. Phone/Fax

Practice location:
  • Phone: 219-662-6151
  • Fax: 219-662-6156
Mailing address:
  • Phone: 317-528-4284
  • Fax: 317-865-8355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number09000074A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: