Healthcare Provider Details

I. General information

NPI: 1790868883
Provider Name (Legal Business Name): JANET ELIZABETH BERNARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 N BAILEY AVE
NORTH PLATTE NE
69101-5436
US

IV. Provider business mailing address

110 N BAILEY AVE P.O. BOX 1208
NORTH PLATTE NE
69101-5436
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-0440
  • Fax: 308-534-7675
Mailing address:
  • Phone: 308-534-0440
  • Fax: 308-534-7675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16458
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number16458
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: