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NPI Code Detail

MEDICARE: JERRI LYNN BRADFORD

MEDICARE: JERRI LYNN BRADFORD
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1386509222
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERRI LYNN BRADFORD
Provider Business Mailing Address
First Line : 3101 SUPERIOR DR NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-1993
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1470 INDUSTRIAL DR NW
Second Line :
City : ROCHESTER
State : MN
Zip : 55901-0700
Country : US
Telephone Number : 507-322-7750
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2025
Last Update Date : 03/23/2026

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Directions to “ JERRI LYNN BRADFORD ” Practice Location

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