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General NPI Number Information
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NPI Number | 1992523955
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Entity Type | Individual
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Provider Name | HEATHER BRADFORD DNP, APRN, CPNP-PC
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Gender | Female
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 612 S CONGRESS BLVD STE A
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City | SMITHVILLE
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State | TN
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Zip | 37166-2009
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Country | US
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Telephone | 931-626-9339
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Fax |
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Provider Business Mailing Address
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Address Line | 1030 S MOUNTAIN ST
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City | SMITHVILLE
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State | TN
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Zip | 37166-2143
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Country | US
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Telephone | 931-626-9339
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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 | 37253
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License Number State | TN
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