Provider Demographics
NPI:1861877029
Name:BERNHARDT, SHAUNDA ELIZABETH (CPHT)
Entity type:Individual
Prefix:MRS
First Name:SHAUNDA
Middle Name:ELIZABETH
Last Name:BERNHARDT
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1939 HARKER WAITS RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45176-9485
Mailing Address - Country:US
Mailing Address - Phone:513-309-0867
Mailing Address - Fax:
Practice Address - Street 1:8680 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4710
Practice Address - Country:US
Practice Address - Phone:513-309-0867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician