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General NPI Number Information
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NPI Number | 1568854347
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Entity Type | Organization
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Legal Business Name | BLUFFTON PEDIATRICS
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Dates
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Enumeration Date | 03/03/2015
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Last Update Date | 03/03/2015
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Provider Practice Location Address
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Address Line | 505 E JEFFERON STREET SUITE A
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City | BLUFFTON
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State | OH
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Zip | 45817
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Country | US
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Telephone | 419-549-5865
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Fax | 567-226-1055
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Provider Business Mailing Address
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Address Line | 505 E JEFFERON STREET SUITE A
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City | BLUFFTON
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State | OH
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Zip | 45817-1349
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Country | US
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Telephone | 419-549-5865
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Fax | 567-226-1055
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. BETH A BISH
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Credential | CNP
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Telephone | 419-549-5865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | COA08524NP
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License Number State | OH
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