Basic Information
| Provider Information | |||||||||
| NPI: | 1306384045 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIEDERSTEDT | ||||||||
| FirstName: | EMELLA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 222 YEAGER ST | ||||||||
| Address2: | |||||||||
| City: | NAPOLEON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 435451036 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4199663294 | ||||||||
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| Practice Location | |||||||||
| Address1: | 701 JEFFERSON AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436046955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4195991660 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2017 | ||||||||
| LastUpdateDate: | 03/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164X00000X | LPN161200 | OH | Y | Nursing Service Providers | Licensed Vocational Nurse |
No ID Information.