Healthcare Provider Details

I. General information

NPI: 1093652786
Provider Name (Legal Business Name): PAIGE ANN BRADLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PAIGE ANN BAKER

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 W 2ND ST
WAYNE NE
68787-1843
US

IV. Provider business mailing address

321 W 2ND ST
WAYNE NE
68787-1843
US

V. Phone/Fax

Practice location:
  • Phone: 515-332-0039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: