Healthcare Provider Details

I. General information

NPI: 1134934581
Provider Name (Legal Business Name): BRADLEY ZOLKE NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 SPRINGHURST BLVD STE 310
LOUISVILLE KY
40241-6162
US

IV. Provider business mailing address

PO BOX 27677
BELFAST ME
04915-2028
US

V. Phone/Fax

Practice location:
  • Phone: 502-447-5633
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4034449
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: