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General NPI Number Information
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NPI Number | 1356833149
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Entity Type | Individual
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Provider Name | CASSIE L. BRADFORD APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 613 23RD ST STE G10
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City | ASHLAND
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State | KY
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Zip | 41101-2886
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Country | US
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Telephone | 606-408-5864
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Fax | 606-408-6499
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Provider Business Mailing Address
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Address Line | 700 ACKERMAN RD STE 2120
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City | COLUMBUS
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State | OH
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Zip | 43202-1559
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Country | US
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Telephone | 614-293-8415
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Fax | 614-293-4044
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 4048490
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.022842
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | APRN.CNP.022842
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License Number State | OH
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