Provider Demographics
NPI:1437479367
Name:BERNAL, JUDY ANN (RPH)
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:BERNAL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7050 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-5113
Mailing Address - Country:US
Mailing Address - Phone:520-790-9492
Mailing Address - Fax:520-747-1460
Practice Address - Street 1:7050 E 22ND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-5113
Practice Address - Country:US
Practice Address - Phone:520-790-9492
Practice Address - Fax:520-747-1460
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6233183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist