Healthcare Provider Details

I. General information

NPI: 1508106972
Provider Name (Legal Business Name): ANNE KATHERINE BEDLEK RN, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2013
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 CLEMSON RD
COLUMBIA SC
29229-8701
US

IV. Provider business mailing address

1300 CLEMSON RD
COLUMBIA SC
29229-8701
US

V. Phone/Fax

Practice location:
  • Phone: 803-736-3183
  • Fax: 803-699-2732
Mailing address:
  • Phone: 803-736-3183
  • Fax: 803-699-2732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRU95765
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: