Provider Demographics
NPI:1427394360
Name:BEDNARCHUK, HEIDI CHRISTINE (ACNS-BC)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:CHRISTINE
Last Name:BEDNARCHUK
Suffix:
Gender:F
Credentials:ACNS-BC
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:CHRISTINE
Other - Last Name:MITTELSTADT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 8673
Mailing Address - Street 2:1025 MARSH ST
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56002-8673
Mailing Address - Country:US
Mailing Address - Phone:507-304-7020
Mailing Address - Fax:
Practice Address - Street 1:1025 MARSH ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-4752
Practice Address - Country:US
Practice Address - Phone:507-304-7020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-21
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 173365-1364SA2200X
MN31364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health