Basic Information
Provider Information
NPI: 1952913634
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEDDINGFIELD
FirstName: HONEY
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 300 PASTEUR DR
Address2:  
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber: 6507234000
FaxNumber:  
Practice Location
Address1: 300 PASTEUR DR
Address2:  
City: STANFORD
State: CA
PostalCode: 943052200
CountryCode: US
TelephoneNumber: 6507234000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/23/2020
LastUpdateDate: 12/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LC0200X95014834CAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
363L00000X95014834CAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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