Healthcare Provider Details

I. General information

NPI: 1699214437
Provider Name (Legal Business Name): BRADSHAW HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2017
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 W BADDOUR PKWY STE 240
LEBANON TN
37087-1510
US

IV. Provider business mailing address

1420 W BADDOUR PKWY STE 240
LEBANON TN
37087-1510
US

V. Phone/Fax

Practice location:
  • Phone: 615-444-4126
  • Fax: 855-785-2890
Mailing address:
  • Phone: 615-444-4126
  • Fax: 855-785-2890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number627
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number20598
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number818
License Number StateTN
# 5
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number5732
License Number StateTN

VIII. Authorized Official

Name: BRENDA M MCFARLIN
Title or Position: OWNER
Credential: APRN-BC
Phone: 615-444-4126