Provider Demographics
NPI:1144284621
Name:BERNARD, MICHELLE LENORA (APRN)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LENORA
Last Name:BERNARD
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:126 MISSOURI AVE
Mailing Address - Street 2:BOX 1239
Mailing Address - City:FORT LEONARD WOOD
Mailing Address - State:MO
Mailing Address - Zip Code:65473-8952
Mailing Address - Country:US
Mailing Address - Phone:573-329-2180
Mailing Address - Fax:573-329-8305
Practice Address - Street 1:800 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-5275
Practice Address - Country:US
Practice Address - Phone:573-814-6580
Practice Address - Fax:573-814-6237
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO096479363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health