Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 17364 | TN |
NPI | 1023357860 |
---|---|
Provider Name | Cynthia Denise Bedford |
First Address | Memphis, TN 38148-0001 |
Second Address | Germantown, TN 38138-3904 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2013 |
Last Update Date | 20/10/2017 |