Healthcare Provider Details

I. General information

NPI: 1952498701
Provider Name (Legal Business Name): BARBARA JUNE BIDEK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 24TH AVENUE SOUTH
NASHVILLE TN
37212-2637
US

IV. Provider business mailing address

368 SANDCASTLE ROAD
FRANKLIN TN
37069
US

V. Phone/Fax

Practice location:
  • Phone: 615-327-5390
  • Fax: 615-321-6359
Mailing address:
  • Phone: 615-673-6202
  • Fax: 615-321-6359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberRN0000051776
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: