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General NPI Number Information
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NPI Number | 1700650660
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Entity Type | Individual
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Provider Name | PAUL BEDNARSKI MSN, RN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 11/10/2023
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 3200 GREENFIELD RD STE 300
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City | DEARBORN
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State | MI
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Zip | 48120-1805
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Country | US
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Telephone | 574-546-1900
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Fax | 574-546-1999
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Provider Business Mailing Address
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Address Line | 2327 9TH ST
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City | WYANDOTTE
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State | MI
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Zip | 48192-4361
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Country | US
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Telephone | 734-306-2744
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704314702
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704314702
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License Number State | MI
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