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General NPI Number Information
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NPI Number | 1063017481
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Entity Type | Individual
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Provider Name | DR. NICHOLAS BERNAUER
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Gender | Male
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 1233 N STATE ST
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City | GREENFIELD
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State | IN
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Zip | 46140-1056
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Country | US
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Telephone | 317-462-7713
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Fax |
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Provider Business Mailing Address
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Address Line | 905 N LAYMAN AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4421
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 26028343A
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License Number State | IN
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