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NPI 1023822632

NPI 1023822632 : JENNIFER BEDDOES RN : LANDER, WY

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General NPI Number Information
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    NPI Number           |    1023822632
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER BEDDOES RN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/04/2025
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    Last Update Date     |    03/05/2025
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Provider Practice Location Address
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    Address Line         |    322 TWEED LN 
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    City                 |    LANDER
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    State                |    WY
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    Zip                  |    82520-9740
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    Country              |    US
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    Telephone            |    307-851-6667
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    322 TWEED LN 
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    City                 |    LANDER
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    State                |    WY
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    Zip                  |    82520-9740
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    Country              |    US
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    Telephone            |    307-851-6667
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    251E00000X
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    Taxonomy Name        |    Home Health Agency
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    License Number       |    30943
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    License Number State |    WY
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