Individual
MRS. WINDY LESTER BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
790 CHURCH ST NE, STE 400, MARIETTA, GA 30060-7282
(770) 405-2976
(770) 988-0730
Mailing address
PO BOX 3157, INDIANAPOLIS, IN 46206-3157
(770) 985-8899
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004722
GA
363AS0400X
Surgical Physician Assistant
004722
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0429PA
—
SC
05
—
162177349A
—
GA
01
—
P00372925
RR MEDICARE
GA
Enumeration date
06/15/2006
Last updated
04/26/2022
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