NPI Code Details Logo

NPI 1457092884

NPI 1457092884 : MARY ELIZABETH BRADSKY DO : KANSAS CITY, KS

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1457092884
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MARY ELIZABETH BRADSKY DO
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/07/2022
-----------------------------------------------------
    Last Update Date     |    11/24/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    3901 RAINBOW BLVD 
-----------------------------------------------------
    City                 |    KANSAS CITY
-----------------------------------------------------
    State                |    KS
-----------------------------------------------------
    Zip                  |    66160-8500
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    913-588-3974
-----------------------------------------------------
    Fax                  |    913-588-6055
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3901 RAINBOW BLVD 
-----------------------------------------------------
    City                 |    KANSAS CITY
-----------------------------------------------------
    State                |    KS
-----------------------------------------------------
    Zip                  |    66160-8500
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    913-588-3974
-----------------------------------------------------
    Fax                  |    913-588-6055
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207R00000X
-----------------------------------------------------
    Taxonomy Name        |    Internal Medicine Physician
-----------------------------------------------------
    License Number       |    80424
-----------------------------------------------------
    License Number State |    MN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    208M00000X
-----------------------------------------------------
    Taxonomy Name        |    Hospitalist Physician
-----------------------------------------------------
    License Number       |    80424
-----------------------------------------------------
    License Number State |    MN
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.