Provider Demographics
NPI:1700213758
Name:BEDNARZYK, MICHELE S (FNP)
Entity Type:Individual
Prefix:PROF
First Name:MICHELE
Middle Name:S
Last Name:BEDNARZYK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNF DRIVE
Mailing Address - Street 2:COLLEGE OF HEALTH, BUILDING 39A
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32224
Mailing Address - Country:US
Mailing Address - Phone:904-620-2684
Mailing Address - Fax:
Practice Address - Street 1:41 E DUVAL ST
Practice Address - Street 2:VOLUNTEERS IN MEDICINE-JAX
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32202-3201
Practice Address - Country:US
Practice Address - Phone:904-620-2684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-07
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2781832363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily