Provider Demographics
NPI:1346069044
Name:BEDWELL, SUSAN MICHELLE (DNP, APRN, CCNS-N)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MICHELLE
Last Name:BEDWELL
Suffix:
Gender:F
Credentials:DNP, APRN, CCNS-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N STONEWALL AVE OFC 467
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73117-1200
Mailing Address - Country:US
Mailing Address - Phone:405-468-6506
Mailing Address - Fax:
Practice Address - Street 1:1200 CHILDRENS AVE STE 5271
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4637
Practice Address - Country:US
Practice Address - Phone:405-271-7341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0051728364SN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SN0000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistNeonatal