Provider Demographics
NPI:1518036847
Name:BERNARD, DEBORAH J (DC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:BERNARD
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 N HATCHER AVE
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3107
Mailing Address - Country:US
Mailing Address - Phone:540-338-2205
Mailing Address - Fax:540-338-2205
Practice Address - Street 1:131 N HATCHER AVE
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3107
Practice Address - Country:US
Practice Address - Phone:540-338-2205
Practice Address - Fax:540-338-2205
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104001080111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA292561OtherBCBS INS PROVIDER #
VAC541683844-001OtherCIGNA INS
VA5822754OtherAETNA INS
VA44-00211OtherUNITED HEALTH CARE