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NPI Code Detail

MEDICARE: CAITLIN E BRADLEY NNP-BC

MEDICARE: CAITLIN E BRADLEY NNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner260045MA
2363LN0005XCritical Care Neonatal Nurse Practitioner260045MA

General Provider Information

NPI Number : 1356651590
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAITLIN E BRADLEY NNP-BC
Provider Business Mailing Address
First Line : 300 LONGWOOD AVE
Second Line :
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number : 617-355-8076
Fax Number :
Provider Business Practice Location Address
First Line : 300 LONGWOOD AVE
Second Line :
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number : 617-355-8076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/20/2010
Last Update Date : 02/27/2020

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Directions to “ CAITLIN E BRADLEY NNP-BC” Practice Location

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