Provider Demographics
NPI:1043732688
Name:BEDNAREK, CHRISTI
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:
Last Name:BEDNAREK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 KENSINGTON CT
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:WI
Mailing Address - Zip Code:53405-4533
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3301 KENSINGTON CT
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:WI
Practice Address - Zip Code:53405-4533
Practice Address - Country:US
Practice Address - Phone:262-220-9154
Practice Address - Fax:262-220-9154
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2017-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Multi-Specialty