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General NPI Number Information
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NPI Number | 1306920731
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Entity Type | Individual
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Provider Name | JACELYN TAYLOR BRADFORD PHARM D
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Gender | Female
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | HIRAM W. DAVIS MEDICAL CENTER PHARMACY W. WASHINGTON STREET
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City | PETERSBURG
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State | VA
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Zip | 23803-0030
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Country | US
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Telephone | 804-524-7346
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Fax | 804-524-4718
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Provider Business Mailing Address
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Address Line | PO BOX 4030 W. WASHINGTON STREET
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City | PETERSBURG
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State | VA
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Zip | 23803-0030
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Country | US
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Telephone | 804-524-7346
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Fax | 804-524-4718
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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 | 0202205891
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 1835P1300X
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Taxonomy Name | Psychiatric Pharmacist
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License Number | 0202205891
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License Number State | VA
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