Individual
MICHELLE C BLEDSOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1506 ANTHONY ST, COLUMBIA, MO 65201-5806
(573) 499-1362
Mailing address
1506 ANTHONY ST, COLUMBIA, MO 65201-5806
(573) 499-1362
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19441964
—
MO
Enumeration date
02/16/2007
Last updated
07/09/2007
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