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General NPI Number Information
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NPI Number | 1003661125
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Entity Type | Individual
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Provider Name | MAREN BRADLEY PHARMD, RPH
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Gender | Female
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 2336 RIDGE CT STE C
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City | LAWRENCE
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State | KS
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Zip | 66046-3913
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Country | US
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Telephone | 785-841-1950
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Fax | 785-841-1051
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Provider Business Mailing Address
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Address Line | 805 MISSISSIPPI ST
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City | LAWRENCE
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State | KS
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Zip | 66044-2660
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Country | US
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Telephone | 816-223-7784
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 1-15955
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License Number State | KS
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