Provider Demographics
NPI:1104159425
Name:BERNYS, NATALIE MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:MARIE
Last Name:BERNYS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 LITTLE RIVER TPKE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3546
Mailing Address - Country:US
Mailing Address - Phone:703-914-3640
Mailing Address - Fax:703-914-2536
Practice Address - Street 1:6715 LITTLE RIVER TPKE
Practice Address - Street 2:SUITE 201
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3546
Practice Address - Country:US
Practice Address - Phone:703-914-3640
Practice Address - Fax:703-914-2536
Is Sole Proprietor?:No
Enumeration Date:2009-09-18
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101053115363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant