MEDICARE: COURTNEY BERNARD

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	11004964	FL

General Provider Information

NPI Number	:	1194360354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY BERNARD

Provider Business Mailing Address
First Line	:	5606 PGA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4122
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5606 PGA BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4122
Country	:	US
Telephone Number	:	561-789-6427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2019
Last Update Date	:	05/05/2026

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Directions to “ COURTNEY BERNARD ” Practice Location

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