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NPI Code Detail

MEDICARE: JENNIFER KAY BLEDSOE

MEDICARE:   JENNIFER KAY BLEDSOE
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1790986834
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER KAY BLEDSOE
Provider Business Mailing Address
First Line : 202 BULLINGTON RD
Second Line :
City : ATHENS
State : AL
Zip : 35611-2315
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9238 MADISON BLVD BLDG 1
Second Line : STE. 1400
City : MADISON
State : AL
Zip : 35758-9100
Country : US
Telephone Number : 256-774-8340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2007
Last Update Date : 07/08/2007

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Directions to “ JENNIFER KAY BLEDSOE ” Practice Location

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