Healthcare Provider Details

I. General information

NPI: 1851415715
Provider Name (Legal Business Name): RINA MARIE BEDFORD RN, CDOE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 BEACH ST
COVENTRY RI
02816-5664
US

IV. Provider business mailing address

18 BEACH ST
COVENTRY RI
02816-5664
US

V. Phone/Fax

Practice location:
  • Phone: 401-828-1938
  • Fax:
Mailing address:
  • Phone: 401-828-1938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number24561
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: