Doctor Name: | MRS. BEVERLY ANN BRADSHAW |
NPI Number: | 1043282502 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APRN BC |
License Number: | 49977 |
Business Practice Address: | 2521 Beechwood Dr Elizabethton, TN - 376435062 |
Business Phone Number: | 4235437919 |
Business Fax Number: | 4235435323 |
Mailing Address: | 2521 Beechwood Dr, ELIZABETHTON |
State: | TN |
Postal Code: | 376435062 |
Phone Number: | 4235437919 |
Fax Number: | 4235435323 |
NPI Enumeration Date: | 02/07/2006 |
NPI Last Update Date: | 04/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 49977 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |