Individual
MARISA BEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2435 SAINT MORITZ DR, LODI, CA 95242-9602
(209) 639-2901
Mailing address
2435 SAINT MORITZ DR, LODI, CA 95242-9602
(209) 639-2901
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
95000574
CA
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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