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NPI Code Detail

MEDICARE: MEGAN G BRADLEY CRNP

MEDICARE: MEGAN G BRADLEY CRNP
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
1363LF0000XFamily Nurse Practitioner1-171592AL

General Provider Information

NPI Number : 1528958774
Entity Type Code : Individual
Provider Name (Legal Business Name) : MEGAN G BRADLEY CRNP
Provider Business Mailing Address
First Line : 30941 MILL LN STE A
Second Line :
City : DAPHNE
State : AL
Zip : 36527-5457
Country : US
Telephone Number : 251-622-1511
Fax Number :
Provider Business Practice Location Address
First Line : 30941 MILL LN STE A
Second Line :
City : DAPHNE
State : AL
Zip : 36527-5457
Country : US
Telephone Number : 251-622-1511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2025
Last Update Date : 07/08/2025

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