| Doctor Name: | MRS. CONSTANCE BRADFORD |
| NPI Number: | 1003960907 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, FNP-C |
| License Number: | R878491 |
| Business Practice Address: | 120 5th Ave Mccomb, MS - 396484159 |
| Business Phone Number: | 6012490013 |
| Business Fax Number: | |
| Mailing Address: | 120 5th Ave, MCCOMB |
| State: | MS |
| Postal Code: | 396484159 |
| Phone Number: | 6012490013 |
| Fax Number: | |
| NPI Enumeration Date: | 01/22/2007 |
| NPI Last Update Date: | 03/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0705X |
| License Number: | R878491 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MS |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |