Individual
BERNARD H AGNEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
1481 HWY 40 E, KINGSLAND, GA 31548-6507
(860) 287-0738
Mailing address
3023 ALBACORE CIR, SILVERDALE, WA 98315-9780
(360) 535-7080
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
—
—
363LF0000X
Family Nurse Practitioner
Primary
RN283456
GA
Other
Enumeration date
06/10/2006
Last updated
03/15/2023
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