Provider Demographics
NPI:1003701525
Name:BERNARDO, RINA LAURENE G
Entity type:Individual
Prefix:
First Name:RINA LAURENE
Middle Name:G
Last Name:BERNARDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3508 BADGER DR SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-4765
Mailing Address - Country:US
Mailing Address - Phone:641-781-3400
Mailing Address - Fax:641-781-3400
Practice Address - Street 1:3508 BADGER DR SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-4765
Practice Address - Country:US
Practice Address - Phone:641-781-3400
Practice Address - Fax:641-781-3400
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA184728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily