Healthcare Provider Details

I. General information

NPI: 1427966183
Provider Name (Legal Business Name): BETHANY NEDROW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 W GARTON RD
OZARK MO
65721
US

IV. Provider business mailing address

PO BOX 215
STURGEON MO
65284-0215
US

V. Phone/Fax

Practice location:
  • Phone: 417-551-9669
  • Fax:
Mailing address:
  • Phone: 260-615-7535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number2026041204
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: