Provider Demographics
NPI:1710949375
Name:BLEDSOE, JANET ELLEN (MSN,APRN,BC,CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JANET
Middle Name:ELLEN
Last Name:BLEDSOE
Suffix:
Gender:F
Credentials:MSN,APRN,BC,CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21260 ALLIGATOR ALY
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-6812
Mailing Address - Country:US
Mailing Address - Phone:443-610-7336
Mailing Address - Fax:
Practice Address - Street 1:410 FOULK RD
Practice Address - Street 2:SUITE 105
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3820
Practice Address - Country:US
Practice Address - Phone:302-762-2285
Practice Address - Fax:302-762-2286
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0040997163WP0808X
DEL8-0000113363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEAN-0008456OtherCSR
MB2522111OtherDEA