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NPI Code Detail

MEDICARE: SONDRA GAIL BEDWELL ANP

MEDICARE: SONDRA GAIL BEDWELL ANP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerA01704AR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538166483
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONDRA GAIL BEDWELL ANP
Provider Business Mailing Address
First Line : 300 E 6TH ST
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-5207
Country : US
Telephone Number : 870-779-6000
Fax Number : 870-779-6119
Provider Business Practice Location Address
First Line : 300 E 6TH ST
Second Line :
City : TEXARKANA
State : AR
Zip : 71854-5207
Country : US
Telephone Number : 870-779-6000
Fax Number : 870-779-6119
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 02/03/2010

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Directions to “ SONDRA GAIL BEDWELL ANP” Practice Location

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