Healthcare Provider Details

I. General information

NPI: 1740193192
Provider Name (Legal Business Name): BRIANA JANE BEDLAN OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 ONYX ST
KEMMERER WY
83101-3214
US

IV. Provider business mailing address

923 CIRCLE DR
FAIRBURY NE
68352-1225
US

V. Phone/Fax

Practice location:
  • Phone: 307-800-8752
  • Fax:
Mailing address:
  • Phone: 307-800-8752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT-1962
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: