Individual
MS. JAN R BERNARD
Active
Individual
MS. JAN R BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11861
NC
2251P0200X
Pediatric Physical Therapist
11861
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0686T
BCBS
—
05
—
7212509
—
NC
Enumeration date
11/06/2008
Last updated
09/18/2019
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