Mary Ann Bednarek, CNM

Individual provider Active NPI Advanced Practice Midwife · Tahlequah, OK

NPI 1104838879 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1104838879
Entity type
Individual (NPI type 1)
Primary specialty
Advanced Practice Midwife 367A00000X
License
57728-032 (WI)
Practice address
100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone
(918) 458-3130
Fax
(918) 458-3511
NPI assigned
Aug 12, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
57728-032WIMDAdvanced Practice Midwife

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 57728-032 WI Yes

Addresses

Primary practice location

100 S Bliss Ave
Tahlequah, OK 74464-2512

Mailing address

100 S Bliss Ave
Tahlequah, OK 74464-2512
Phone (918) 458-3130

Other providers in Tahlequah, OK

All providers in Tahlequah, OK · Advanced Practice Midwife in Oklahoma

Sources for this page

Verify at the official NPI Registry.