Provider Demographics
NPI:1316625858
Name:BERNAL, JEIMY J
Entity type:Individual
Prefix:
First Name:JEIMY
Middle Name:J
Last Name:BERNAL
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 1:1977 MESA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-3437
Mailing Address - Country:US
Mailing Address - Phone:775-460-8125
Mailing Address - Fax:
Practice Address - Street 1:1977 MESA VISTA DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-3437
Practice Address - Country:US
Practice Address - Phone:775-460-8125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide