Provider Demographics
NPI:1063898633
Name:BEDELLS, KAREN (NP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:BEDELLS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 DAUGHDRILL STA
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-8406
Mailing Address - Country:US
Mailing Address - Phone:601-992-9790
Mailing Address - Fax:
Practice Address - Street 1:140 DAUGHDRILL STA
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8406
Practice Address - Country:US
Practice Address - Phone:601-992-9790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-06
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR733261363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily