Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | C46780 | NC |
NPI | 1811167521 |
---|---|
Provider Name | Christina Bernard |
First Address | Durham, NC 27713-6646 |
Second Address | Durham, NC 27713-6646 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 05/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1619935913 | ADVANCED HOME CARE INC; EMPLOYER (01) | NC |