MEDICARE: BERNIE JUSTICE ARNP

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	363LF0000X	Family Nurse Practitioner	3006127	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679702492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNIE JUSTICE ARNP

Provider Business Mailing Address
First Line	:	PO BOX 432
Second Line	:
City	:	PIKEVILLE
State	:	KY
Zip	:	41502-0432
Country	:	US
Telephone Number	:	606-430-2230
Fax Number	:	606-437-2027

Provider Business Practice Location Address
First Line	:	911 BYPASS RD BLDG A
Second Line	:
City	:	PIKEVILLE
State	:	KY
Zip	:	41501-1602
Country	:	US
Telephone Number	:	606-430-2120
Fax Number	:	606-437-2573

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

Provider Enumeration Date	:	07/14/2009
Last Update Date	:	03/27/2026

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