Healthcare Provider Details

I. General information

NPI: 1528059466
Provider Name (Legal Business Name): ANDREA J BEDWAY CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 01/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 OLENTANGY RIVER RD
COLUMBUS OH
43212-3120
US

IV. Provider business mailing address

5350 FRANTZ RD
DUBLIN OH
43016-4259
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-3743
  • Fax: 614-566-6846
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberCOA01787NS
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: