Provider Demographics
NPI:1225231392
Name:BIDIGARE, CECILIA MARY (RN-CS MSN)
Entity Type:Individual
Prefix:MS
First Name:CECILIA
Middle Name:MARY
Last Name:BIDIGARE
Suffix:
Gender:F
Credentials:RN-CS MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1052 GROVE HILL DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45434-5906
Mailing Address - Country:US
Mailing Address - Phone:937-427-0642
Mailing Address - Fax:
Practice Address - Street 1:1052 GROVE HILL DR
Practice Address - Street 2:
Practice Address - City:BEAVERCREEK
Practice Address - State:OH
Practice Address - Zip Code:45434-5906
Practice Address - Country:US
Practice Address - Phone:937-427-0642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 199904-COA1163WG0000X, 163WM0705X, 163WW0000X, 163WX1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Not Answered163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Not Answered163WW0000XNursing Service ProvidersRegistered NurseWound Care
Not Answered163WX1500XNursing Service ProvidersRegistered NurseOstomy Care