Provider Demographics
NPI:1699101691
Name:BEDSWORTH, JANA (OTR)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:BEDSWORTH
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 SE PARKWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-4712
Mailing Address - Country:US
Mailing Address - Phone:816-560-1391
Mailing Address - Fax:
Practice Address - Street 1:713 SE PARKWOOD CT
Practice Address - Street 2:
Practice Address - City:BLUE SPRINGS
Practice Address - State:MO
Practice Address - Zip Code:64014-4712
Practice Address - Country:US
Practice Address - Phone:816-560-1391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS17-02921225X00000X
MO2013023638225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist