MEDICARE: MRS. JONNA ARNO BRADLEY ARNP

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	363LF0000X	Family Nurse Practitioner	1896452	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962482224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JONNA ARNO BRADLEY ARNP

Provider Business Mailing Address
First Line	:	PO BOX 676
Second Line	:
City	:	CHATTAHOOCHEE
State	:	FL
Zip	:	32324-0676
Country	:	US
Telephone Number	:	850-593-5037
Fax Number	:

Provider Business Practice Location Address
First Line	:	278 LASALLE LEFALL DR
Second Line	:
City	:	QUINCY
State	:	FL
Zip	:	32351-5324
Country	:	US
Telephone Number	:	850-875-7500
Fax Number	:	850-875-3618

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

Provider Enumeration Date	:	01/20/2006
Last Update Date	:	12/12/2012

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