Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LN0000X | Nurse Practitioner - Neonatal | 002772 | CT |
Y | 363LN0000X | Nurse Practitioner - Neonatal | APN001275 | NV |
NPI | 1164588026 |
---|---|
Provider Name | Dawn P. Bernardo |
First Address | Farmington, CT 06030-0001 |
Second Address | Farmington, CT 06030-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2006 |
Last Update Date | 21/03/2012 |