Healthcare Provider Details

I. General information

NPI: 1134362015
Provider Name (Legal Business Name): SARAH EVELYN BRADSHAW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. SARAH EVELYN BAPTIST-NGUYEN

II. Dates (important events)

Enumeration Date: 04/08/2009
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2051 N STATE ST
IOLA KS
66749-1677
US

IV. Provider business mailing address

PO BOX 1832
PITTSBURG KS
66762-1832
US

V. Phone/Fax

Practice location:
  • Phone: 620-380-6600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2012011120
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0435805
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number0435805
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: