Individual
BETHELEM WONDIMU BEDASSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7450 QUIVIRA RD, SHAWNEE, KS 66216-3526
(913) 706-2508
Mailing address
7450 QUIVIRA RD, SHAWNEE, KS 66216-3526
(913) 706-2508
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
53-82444-092
KS
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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