Provider Demographics
NPI:1053942607
Name:BERNARDO DA SILVA ZARDO, JULIANA (PNP)
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:BERNARDO DA SILVA ZARDO
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 MISTY WOOD CT NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-1650
Mailing Address - Country:US
Mailing Address - Phone:720-557-9130
Mailing Address - Fax:
Practice Address - Street 1:1230 JOHNSON FERRY PL
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2048
Practice Address - Country:US
Practice Address - Phone:678-501-5601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA282284363LP0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse