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General NPI Number Information
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NPI Number | 1851753131
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Entity Type | Individual
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Provider Name | DEBORAH BRADLEY CPNP
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Gender | Female
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Dates
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Enumeration Date | 03/24/2016
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 3882 SNOWY REACH CIR
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City | ELIZABETH
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State | CO
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Zip | 80107-8226
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Country | US
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Telephone | 303-359-9553
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3312
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City | PARKER
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State | CO
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Zip | 80134-1432
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Country | US
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Telephone |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 93888
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License Number State | CO
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