Individual
MRS. JAIME BEDENBAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
416 ELM ST, PROSPERITY, SC 29127-7250
(806) 445-2141
Mailing address
416 ELM ST, PROSPERITY, SC 29127-7250
(864) 445-2181
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P 39336
SC
Other
Enumeration date
03/16/2015
Last updated
03/16/2015
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