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General NPI Number Information
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NPI Number | 1508879875
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Entity Type | Individual
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Provider Name | JANICE J BRADLEY NP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 1005 S CROWLEY RD
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City | CROWLEY
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State | TX
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Zip | 76036-4282
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Country | US
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Telephone | 817-297-4455
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Fax | 817-295-3022
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Provider Business Mailing Address
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Address Line | 1813 RANGEWAY DR
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City | JOSHUA
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State | TX
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Zip | 76058-5273
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Country | US
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Telephone | 817-528-5491
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 647046
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License Number State | TX
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