| Doctor Name: | BERNADETTE H HARRELSON |
| NPI Number: | 1205861192 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PAC |
| License Number: | PA9101821 |
| Business Practice Address: | 520 N Lecanto Hwy Lecanto, FL - 344618547 |
| Business Phone Number: | 3525274444 |
| Business Fax Number: | 3527467829 |
| Mailing Address: | 70 N Lecanto Hwy, LECANTO |
| State: | FL |
| Postal Code: | 344619190 |
| Phone Number: | 3525276699 |
| Fax Number: | 3527460720 |
| NPI Enumeration Date: | 07/11/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA9101821 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |