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General NPI Number Information
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NPI Number | 1972821429
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Entity Type | Individual
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Provider Name | KIMBERLY S BRADLEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/07/2010
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Last Update Date | 05/07/2010
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Provider Practice Location Address
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Address Line | 5148 HIGHWAY 51 N
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City | SENATOBIA
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State | MS
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Zip | 38668-1720
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Country | US
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Telephone | 662-562-9366
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Fax | 662-562-9353
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Provider Business Mailing Address
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Address Line | 5148 HIGHWAY 51 N
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City | SENATOBIA
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State | MS
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Zip | 38668-1720
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Country | US
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Telephone | 662-562-9366
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Fax | 662-562-9353
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E-010420
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License Number State | MS
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