Healthcare Provider Details

I. General information

NPI: 1366386047
Provider Name (Legal Business Name): SARAH LYNSI BRADBURY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13906 GOLD CIR STE 103
OMAHA NE
68144-2336
US

IV. Provider business mailing address

5050 S 86TH PKWY APT 9
OMAHA NE
68127-2683
US

V. Phone/Fax

Practice location:
  • Phone: 402-706-0772
  • Fax:
Mailing address:
  • Phone: 402-706-0772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: