Provider Demographics
NPI:1336950559
Name:PEARSON, BERNADETTE (PHLEBOTOMIST, CNA)
Entity type:Individual
Prefix:MS
First Name:BERNADETTE
Middle Name:
Last Name:PEARSON
Suffix:
Gender:F
Credentials:PHLEBOTOMIST, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2753
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-1741
Mailing Address - Country:US
Mailing Address - Phone:470-781-3935
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 2753
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-1741
Practice Address - Country:US
Practice Address - Phone:470-781-3935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-16
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3747P1801X, 246RP1900X
GACN0014188521376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376K00000XNursing Service Related ProvidersNurse's Aide