Healthcare Provider Details

I. General information

NPI: 1073955928
Provider Name (Legal Business Name): LINDSAY G BEDORA RN, APRN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY G HARTLEY

II. Dates (important events)

Enumeration Date: 07/20/2013
Last Update Date: 10/28/2021
Certification Date: 10/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19550 E 39TH ST S SUITE 300
INDEPENDENCE MO
64057-2303
US

IV. Provider business mailing address

1611 DEER RUN RD
OAK GROVE MO
64075-5210
US

V. Phone/Fax

Practice location:
  • Phone: 816-478-0220
  • Fax:
Mailing address:
  • Phone: 816-478-0220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number2013025600
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: