Bernardo Black, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

55487 Issued in NM

Practice address

WSTF/Nasa Clinic
12600 Nasa Road BLDG. 104-E
Las Cruces, NM 88012-1298

Phone

(575) 524-5213

NPI assigned

Mar 5, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1245798586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WSTF/NASA CLINIC",
            "address_2": "12600 NASA ROAD BLDG. 104-E",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880121298",
            "telephone_number": "575-524-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WSTF/NASA CLINIC",
            "address_2": "12600 NASA ROAD BLDG. 104-E",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880121298",
            "telephone_number": "575-524-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "BERNARDO",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-05",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "55487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Bittner
• Kennen Bitton, DPT
• Judith L. Bixby, RN
• Briana Bixler, DPT
• Nautica Bizieff
• Briana Kay Black
• Chandra Black
• Cheryl Ann Black, PH.D
• Elizabeth Black, LMHC
• Crystal Blackburn, CRNA

• Family Nurse Practitioner in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Family Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.