Provider Demographics
NPI:1376901058
Name:BEDWELL, DEBORAH (APN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:BEDWELL
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2229 MARY SHERMAN DR
Mailing Address - Street 2:PO BOX 230
Mailing Address - City:SULLIVAN
Mailing Address - State:IN
Mailing Address - Zip Code:47882-7633
Mailing Address - Country:US
Mailing Address - Phone:812-268-3318
Mailing Address - Fax:
Practice Address - Street 1:8685 OLD HIGHWAY 41 SOUTH
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:IN
Practice Address - Zip Code:47838-8234
Practice Address - Country:US
Practice Address - Phone:812-398-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71006094A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily