Healthcare Provider Details

I. General information

NPI: 1326070012
Provider Name (Legal Business Name): ROBIN J. BERNARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 10/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2740 N CLARKSON ST
FREMONT NE
68025
US

IV. Provider business mailing address

4321 41ST AVE
COLUMBUS NE
68601-2131
US

V. Phone/Fax

Practice location:
  • Phone: 402-721-0951
  • Fax:
Mailing address:
  • Phone: 402-562-7500
  • Fax: 402-564-0611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number21066
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: