Provider Demographics
NPI:1952594194
Name:BEDNAR, EMILY JANE (ARNP, BC)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:JANE
Last Name:BEDNAR
Suffix:
Gender:F
Credentials:ARNP, BC
Other - Prefix:MISS
Other - First Name:EMILY
Other - Middle Name:JANE
Other - Last Name:GLEICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:550 30TH AVE
Mailing Address - Street 2:SUITE 12
Mailing Address - City:MOLINE
Mailing Address - State:IL
Mailing Address - Zip Code:61265-5975
Mailing Address - Country:US
Mailing Address - Phone:309-762-5515
Mailing Address - Fax:
Practice Address - Street 1:550 30TH AVE
Practice Address - Street 2:SUITE 12
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-5975
Practice Address - Country:US
Practice Address - Phone:309-762-5515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA-112531363LF0000X
IL363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily