Individual
VICTORIA BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
619 S WASHINGTON ST, MOSCOW, ID 83843-3090
(209) 892-1346
Mailing address
6285 GOLDFINCH DR, PRESCOTT, AZ 86305-6106
(315) 651-6898
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
8987
AZ
207Q00000X
Family Medicine Physician
Primary
PA1831
ID
Other
Enumeration date
11/21/2019
Last updated
12/28/2023
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