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General NPI Number Information
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NPI Number | 1447116587
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Entity Type | Organization
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Legal Business Name | CASSANDRA BRADLEY DBA LAKE LOVELAND ANESTHESIA
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Dates
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Enumeration Date | 01/02/2026
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 1355 RIVERSIDE AVE STE C
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City | FORT COLLINS
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State | CO
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Zip | 80524-4366
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Country | US
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Telephone | 970-484-4620
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7117
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City | LOVELAND
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State | CO
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Zip | 80537-0117
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Country | US
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Telephone | 970-290-7403
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA BRADLEY
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Credential | CRNA
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Telephone | 970-290-7403
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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