Individual
FAITH BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5521 W LINCOLN HWY STE 1A, CROWN POINT, IN 46307-1098
(219) 769-1362
Mailing address
5521 W LINCOLN HWY STE 1A, CROWN POINT, IN 46307-1098
(773) 934-1761
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71013214B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28163799A
REGISTERED NURSE LICENSE NUMBER
IN
01
—
5370-02-5142
DRIVER'S LICENSE NUMBER
IN
Enumeration date
11/02/2022
Last updated
11/02/2022
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