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NPI Code Detail

MEDICARE: SYLVIA ANNE BRADLEY NP-C

MEDICARE: SYLVIA ANNE BRADLEY NP-C
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
1363LA2200XAdult Health Nurse Practitioner175479CO
2363LA2200XAdult Health Nurse Practitioner678069TX

General Provider Information

NPI Number : 1952397416
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYLVIA ANNE BRADLEY NP-C
Provider Business Mailing Address
First Line : 6986 DOVE CREEK DR
Second Line :
City : WYLIE
State : TX
Zip : 75098-7750
Country : US
Telephone Number : 972-442-1930
Fax Number :
Provider Business Practice Location Address
First Line : 8615 LULLWATER DR
Second Line :
City : DALLAS
State : TX
Zip : 75238-4754
Country : US
Telephone Number : 214-221-0444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 01/18/2012

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