Provider Demographics
NPI:1962726232
Name:BEDELL, JOSIE ELLA (LPN)
Entity type:Individual
Prefix:MS
First Name:JOSIE
Middle Name:ELLA
Last Name:BEDELL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4323 BREEZEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45406-1315
Mailing Address - Country:US
Mailing Address - Phone:937-277-4705
Mailing Address - Fax:
Practice Address - Street 1:4323 BREEZEWOOD AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1315
Practice Address - Country:US
Practice Address - Phone:937-277-4705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-16
Last Update Date:2010-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN015373-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse