Terri Bard, LPN

Individual provider Active NPI Licensed Practical Nurse · Berkley, MI

NPI 1124417332 · NPPES record last updated Jan 12, 2015

Key facts

NPI
1124417332
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703099185 (MI)
Practice address
2766 11 Mile Rd Ste 2
Berkley, MI 48072-3033
Phone
(248) 542-2424
Fax
(248) 542-5621
NPI assigned
Jan 12, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703099185MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703099185 MI Yes

Addresses

Primary practice location

2766 11 Mile Rd Ste 2
Berkley, MI 48072-3033

Mailing address

39040 Nottingham Dr
Romulus, MI 48174-6305
Phone (248) 747-1757

Other providers in Berkley, MI

All providers in Berkley, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.