MEDICARE: BERNIKA ANITA NICOLE TODD

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	246RP1900X	Phlebotomy Technician		GA

General Provider Information

NPI Number	:	1992569966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERNIKA ANITA NICOLE TODD

Provider Business Mailing Address
First Line	:	3800 CAMP CREEK PKWY SW BLDG 1400
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-6247
Country	:	US
Telephone Number	:	800-814-9505
Fax Number	:

Provider Business Practice Location Address
First Line	:	4518 SWAN TRCE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30349-1664
Country	:	US
Telephone Number	:	678-245-2514
Fax Number	:

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

Provider Enumeration Date	:	02/09/2024
Last Update Date	:	02/09/2024

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