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General NPI Number Information
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NPI Number | 1366324907
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Entity Type | Individual
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Provider Name | SEAN BRADLEY NINE APRN
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Gender | Male
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 802 CLARE AVE
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2583
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Country | US
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Telephone | 740-876-8449
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Fax |
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Provider Business Mailing Address
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Address Line | 140 FOREST HTS
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City | HUNTINGTON
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State | WV
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Zip | 25705-7174
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Country | US
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Telephone | 304-634-6021
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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 | 123499
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License Number State | WV
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