Provider Demographics
NPI:1992483754
Name:BEDNARA, EVA MARIE
Entity type:Individual
Prefix:MISS
First Name:EVA
Middle Name:MARIE
Last Name:BEDNARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8109 45TH CT
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:IL
Mailing Address - Zip Code:60534-1811
Mailing Address - Country:US
Mailing Address - Phone:407-393-8859
Mailing Address - Fax:
Practice Address - Street 1:8109 45TH CT
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:IL
Practice Address - Zip Code:60534-1811
Practice Address - Country:US
Practice Address - Phone:407-393-8859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide