Provider Demographics
NPI:1548368236
Name:BERNARD, GLORIA JEAN (RN, ANP)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:JEAN
Last Name:BERNARD
Suffix:
Gender:F
Credentials:RN, ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5050 QUORUM DR
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75252
Mailing Address - Country:US
Mailing Address - Phone:180-040-9192
Mailing Address - Fax:
Practice Address - Street 1:5050 QUORUM DR
Practice Address - Street 2:SUITE 700
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75252
Practice Address - Country:US
Practice Address - Phone:180-040-9192
Practice Address - Fax:800-878-3830
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP112157363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health