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NPI Code Detail

MEDICARE: STEVEN BRADBURY RN

MEDICARE: STEVEN BRADBURY RN
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
1163W00000XRegistered Nurse239794OH

General Provider Information

NPI Number : 1629923644
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN BRADBURY RN
Provider Business Mailing Address
First Line : 17273 STATE ROUTE 104
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-9718
Country : US
Telephone Number : 740-993-8569
Fax Number :
Provider Business Practice Location Address
First Line : 17273 STATE ROUTE 104
Second Line :
City : CHILLICOTHEE
State : OH
Zip : 45601-9718
Country : US
Telephone Number : 740-773-1141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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