Individual
KIMBERLY LEGGETT BEDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Mailing address
2080 W ARLINGTON BLVD STE B, GREENVILLE, NC 27834-3770
(252) 752-2140
(252) 689-6502
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
138553
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
2113
NC
367500000X
Certified Registered Nurse Anesthetist
54452
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1851435218
TRICARE
NC
05
—
8051977
—
NC
01
—
P00601241
RAILROAD MEDICARE
NC
Enumeration date
02/19/2007
Last updated
05/20/2021
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