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NPI Code Detail

MEDICARE: MARYLYNN BERNIER MSN,RN,CS

MEDICARE: MARYLYNN BERNIER MSN,RN,CS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN326522LPA
2163WP0809XAdult Psychiatric/Mental Health Registered Nurse26NJ00011300NJ

General Provider Information

NPI Number : 1184857583
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARYLYNN BERNIER MSN,RN,CS
Provider Business Mailing Address
First Line : 6 HANOVER DR
Second Line :
City : MEDFORD
State : NJ
Zip : 08055-8621
Country : US
Telephone Number : 609-440-4471
Fax Number :
Provider Business Practice Location Address
First Line : 100 W LEHIGH AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19133-4039
Country : US
Telephone Number : 215-779-1794
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2009
Last Update Date : 09/01/2009

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