MEDICARE: MRS. ABBIE LYNN BLEDSOE NP

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	363LF0000X	Family Nurse Practitioner	71006075B	IN
2	363LF0000X	Family Nurse Practitioner	71006075A	IN

General Provider Information

NPI Number	:	1568821718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ABBIE LYNN BLEDSOE NP

Provider Business Mailing Address
First Line	:	1177 SHEFFIELD CT
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-3146
Country	:	US
Telephone Number	:	317-966-9567
Fax Number	:

Provider Business Practice Location Address
First Line	:	520 TRACY RD
Second Line	:
City	:	WHITELAND
State	:	IN
Zip	:	46184-9373
Country	:	US
Telephone Number	:	317-535-7447
Fax Number	:	317-535-0262

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

Provider Enumeration Date	:	02/16/2016
Last Update Date	:	02/16/2016

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