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NPI Code Detail

MEDICARE: JILL S BERNHARDT NP

MEDICARE: JILL S BERNHARDT NP
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
1363L00000XNurse PractitionerF332981NY

General Provider Information

NPI Number : 1992773105
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL S BERNHARDT NP
Provider Business Mailing Address
First Line : 39 NORBROOK RD
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-8959
Country : US
Telephone Number : 585-425-3506
Fax Number : 585-359-5045
Provider Business Practice Location Address
First Line : 2034 LEHIGH STATION RD
Second Line :
City : HENRIETTA
State : NY
Zip : 14467-9616
Country : US
Telephone Number : 585-359-5028
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 03/17/2018

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