Provider Demographics
NPI:1639889181
Name:BIDWELL, CHRISTEN LEA (RN)
Entity type:Individual
Prefix:
First Name:CHRISTEN
Middle Name:LEA
Last Name:BIDWELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 JACOBS HILL RD
Mailing Address - Street 2:
Mailing Address - City:SHINGLEHOUSE
Mailing Address - State:PA
Mailing Address - Zip Code:16748-5118
Mailing Address - Country:US
Mailing Address - Phone:814-697-6969
Mailing Address - Fax:814-697-7626
Practice Address - Street 1:1 LEO MOSS DR
Practice Address - Street 2:
Practice Address - City:OLEAN
Practice Address - State:NY
Practice Address - Zip Code:14760-1100
Practice Address - Country:US
Practice Address - Phone:716-701-3408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730598-01163WH0200X
NY355061363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No163WH0200XNursing Service ProvidersRegistered NurseHome Health