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General NPI Number Information
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NPI Number | 1306718242
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Entity Type | Individual
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Provider Name | AIYANA BRADFORD CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/20/2025
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Last Update Date | 10/24/2025
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Provider Practice Location Address
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Address Line | 124 DONALD LN
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City | JOHNSTOWN
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State | PA
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Zip | 15904-2815
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Country | US
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Telephone | 814-915-4539
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 432
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City | PRIMOS SECANE
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State | PA
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Zip | 19018-0432
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Country | US
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Telephone | 610-580-5180
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | SP032005
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | SP032005
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License Number State | PA
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