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NPI Code Detail

MEDICARE: ALICE MICHELLE BLEDSOE CDCA

MEDICARE: ALICE MICHELLE BLEDSOE CDCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorCDCA.164444OH

General Provider Information

NPI Number : 1144730516
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE MICHELLE BLEDSOE CDCA
Provider Business Mailing Address
First Line : 1515 CARLL ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45225-2012
Country : US
Telephone Number : 513-872-8884
Fax Number :
Provider Business Practice Location Address
First Line : 1515 CARLL ST
Second Line :
City : CINCINNATI
State : OH
Zip : 45225-2012
Country : US
Telephone Number : 513-872-8884
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2017
Last Update Date : 10/11/2017

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Directions to “ ALICE MICHELLE BLEDSOE CDCA” Practice Location

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