Healthcare Provider Details

I. General information

NPI: 1063898633
Provider Name (Legal Business Name): KAREN BEDELLS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2015
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 DAUGHDRILL STA
FLOWOOD MS
39232-8406
US

IV. Provider business mailing address

140 DAUGHDRILL STA
FLOWOOD MS
39232-8406
US

V. Phone/Fax

Practice location:
  • Phone: 601-992-9790
  • Fax:
Mailing address:
  • Phone: 601-992-9790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR733261
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: