Individual
KATHERINE MALLORY BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3400 SPRUCE ST, PHILADELPHIA, PA 19104-4238
(267) 408-4905
Mailing address
4713 BALTIMORE AVE # 3, PHILADELPHIA, PA 19143-2014
(267) 408-4905
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP021490
PA
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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