Provider Demographics
NPI:1053129783
Name:BEDNARZ, BREANNA KAE
Entity type:Individual
Prefix:MRS
First Name:BREANNA
Middle Name:KAE
Last Name:BEDNARZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BREANNA
Other - Middle Name:KAE
Other - Last Name:PATIENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1924 W 38TH DR APT 2
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68845-2274
Mailing Address - Country:US
Mailing Address - Phone:308-233-1058
Mailing Address - Fax:
Practice Address - Street 1:1924 W 38TH DR APT 2
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68845-2274
Practice Address - Country:US
Practice Address - Phone:308-233-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-27
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant