Provider Demographics
NPI:1457464059
Name:BENDELE, JOHN GERARD JR (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:GERARD
Last Name:BENDELE
Suffix:JR
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3094 CARTHAGE RD
Mailing Address - Street 2:
Mailing Address - City:CALIFORNIA
Mailing Address - State:KY
Mailing Address - Zip Code:41007-9236
Mailing Address - Country:US
Mailing Address - Phone:859-635-3011
Mailing Address - Fax:
Practice Address - Street 1:3200 VINE STREET
Practice Address - Street 2:VETERANS AFFAIRS MEDICAL CENTER
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45020
Practice Address - Country:US
Practice Address - Phone:513-475-6477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNA-03647367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered