Healthcare Provider Details

I. General information

NPI: 1215295654
Provider Name (Legal Business Name): BERNADETTE FOURNIER RNFA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2012
Last Update Date: 04/23/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4805 PINESPRINGS DR
RENO NV
89509-6504
US

IV. Provider business mailing address

4805 PINESPRINGS DR
RENO NV
89509-6504
US

V. Phone/Fax

Practice location:
  • Phone: 775-742-8393
  • Fax: 775-826-3841
Mailing address:
  • Phone: 775-742-8393
  • Fax: 775-826-3841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN11867
License Number StateNV

VIII. Authorized Official

Name: MS. BERNADETTE FOURNIER
Title or Position: MANAGING MEMBER
Credential: RNFA
Phone: 775-742-8393