Individual
JASON DWIGHT BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4105 N WATER TOWER PL, MOUNT VERNON, IL 62864-6296
(618) 244-9495
Mailing address
4105 N WATER TOWER PL, MOUNT VERNON, IL 62864-6296
(618) 244-9495
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
041501842
IL
363L00000X
Nurse Practitioner
Primary
209.035119
IL
Other
Enumeration date
02/11/2026
Last updated
03/27/2026
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