Healthcare Provider Details

I. General information

NPI: 1306070297
Provider Name (Legal Business Name): MARCI R BRADFORD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARCI R LANG NP

II. Dates (important events)

Enumeration Date: 05/07/2009
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 ROSS AVE STE 14
SCHOFIELD WI
54476-6104
US

IV. Provider business mailing address

320 ROSS AVE STE 14
SCHOFIELD WI
54476-6104
US

V. Phone/Fax

Practice location:
  • Phone: 715-359-8725
  • Fax:
Mailing address:
  • Phone: 715-359-8725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number148371
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3731
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: