MEDICARE: RINA MARIE BEDFORD RN, CDOE

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
1	163WD0400X	Diabetes Educator Registered Nurse	24561	RI

General Provider Information

NPI Number	:	1851415715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RINA MARIE BEDFORD RN, CDOE

Provider Business Mailing Address
First Line	:	18 BEACH ST
Second Line	:
City	:	COVENTRY
State	:	RI
Zip	:	02816-5664
Country	:	US
Telephone Number	:	401-828-1938
Fax Number	:

Provider Business Practice Location Address
First Line	:	18 BEACH ST
Second Line	:
City	:	COVENTRY
State	:	RI
Zip	:	02816-5664
Country	:	US
Telephone Number	:	401-828-1938
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2007
Last Update Date	:	07/08/2007

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