MEDICARE: MS. CECILIA MARY BIDIGARE RN-CS MSN

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
1	163WG0000X	General Practice Registered Nurse	RN 199904-COA1	OH
2	163WM0705X	Medical-Surgical Registered Nurse	RN 199904-COA1	OH
3	163WW0000X	Wound Care Registered Nurse	RN 199904-COA1	OH
4	163WX1500X	Ostomy Care Registered Nurse	RN 199904-COA1	OH

General Provider Information

NPI Number	:	1225231392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CECILIA MARY BIDIGARE RN-CS MSN

Provider Business Mailing Address
First Line	:	1052 GROVE HILL DRIVE
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45434-5906
Country	:	US
Telephone Number	:	937-427-0642
Fax Number	:

Provider Business Practice Location Address
First Line	:	1052 GROVE HILL DR
Second Line	:
City	:	BEAVERCREEK
State	:	OH
Zip	:	45434-5906
Country	:	US
Telephone Number	:	937-427-0642
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	09/11/2025

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