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General NPI Number Information
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NPI Number | 1437793056
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Entity Type | Individual
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Provider Name | KATRINA ANN BERNARD PA-C
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Gender | Female
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Dates
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Enumeration Date | 11/06/2019
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Last Update Date | 10/16/2020
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Provider Practice Location Address
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Address Line | 15435 W 134TH PL
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City | OLATHE
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State | KS
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Zip | 66062-6135
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Country | US
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Telephone | 802-881-7520
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Fax |
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Provider Business Mailing Address
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Address Line | 1310 NW 74TH PL
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City | KANSAS CITY
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State | MO
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Zip | 64118-8410
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Country | US
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Telephone | 802-881-7520
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 15-02365
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 055.0031443
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1539
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License Number State | NH
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