MEDICARE: SHELBYLYN TEALE BRADLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	LPN14011	MA

General Provider Information

NPI Number	:	1972437465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELBYLYN TEALE BRADLEY

Provider Business Mailing Address
First Line	:	50 MAYNARD ST APT 128
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-3061
Country	:	US
Telephone Number	:	774-219-7426
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 MAYNARD ST APT 128
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-3061
Country	:	US
Telephone Number	:	774-219-7426
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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Directions to “ SHELBYLYN TEALE BRADLEY ” Practice Location

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