Individual
MRS. STEPHANIE CARROLL BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, RD
Contact information
Practice address
44160 SCHOLAR PLZ, LEESBURG, VA 20176-3459
(540) 542-6546
Mailing address
20893 FOWLERS MILL CIR, ASHBURN, VA 20147-4810
(617) 571-7194
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005158
VA
Other
Enumeration date
03/10/2007
Last updated
05/04/2017
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