Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 2013025600 | MO |
NPI | 1073955928 |
---|---|
Provider Name | Mrs. Lindsay G Bedora |
First Address | Oak Grove, MO 64075-5210 |
Second Address | Independence, MO 64057-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2013 |
Last Update Date | 28/10/2021 |