Healthcare Provider Details

I. General information

NPI: 1609762939
Provider Name (Legal Business Name): BAYAN BEDOOR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BAYAN ALJARABAH

II. Dates (important events)

Enumeration Date: 06/13/2025
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 W PATERSON ST
KALAMAZOO MI
49007-2581
US

IV. Provider business mailing address

3051 MEADOWCROFT LN
KALAMAZOO MI
49004-3774
US

V. Phone/Fax

Practice location:
  • Phone: 269-903-5941
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704354197
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: