Healthcare Provider Details

I. General information

NPI: 1538446018
Provider Name (Legal Business Name): ZACHARY LENNON BRADLEY NREMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2011
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 9TH ST STE 0040 VHA- EMERGENCY MANAGEMENT
KANSAS CITY MO
64106-2607
US

IV. Provider business mailing address

395 BIDDLE BLVD BLDG 2101
FORT LEAVENWORTH KS
66027-2307
US

V. Phone/Fax

Practice location:
  • Phone: 800-525-1483
  • Fax: 816-842-0885
Mailing address:
  • Phone: 816-701-3213
  • Fax: 913-684-2877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number StateNULL
# 6
Primary TaxonomyY
Taxonomy Code1710I1003X
TaxonomyIndependent Duty Medical Technicians
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: