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General NPI Number Information
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NPI Number | 1104843762
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Entity Type | Individual
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Provider Name | DONNA LEE BLEDSOE APRN, BC
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Gender | Female
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 FREEDOM WAY
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City | AUGUSTA
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State | GA
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Zip | 30904-6258
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Country | US
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Telephone | 706-733-0188
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Fax | 706-731-7293
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Provider Business Mailing Address
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Address Line | 5375 VICTORIA FLS
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City | GROVETOWN
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State | GA
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Zip | 30813-5201
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Country | US
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Telephone | 706-651-1638
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Fax | 706-854-9758
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | RN030479
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License Number State | GA
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