MEDICARE: MS. NATALIE BRADSHAW MS, CCC-SLP

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
1	235Z00000X	Speech-Language Pathologist	0003335	CO

General Provider Information

NPI Number	:	1942785126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. NATALIE BRADSHAW MS, CCC-SLP

Provider Business Mailing Address
First Line	:	3030 S COLLEGE AVE UNIT 210
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2557
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3030 S COLLEGE AVE UNIT 210
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2557
Country	:	US
Telephone Number	:	435-659-1380
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2018
Last Update Date	:	05/23/2025

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