| Doctor Name: | NANCY L BRADSHAW |
| NPI Number: | 1063596096 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, CNP |
| License Number: | R115681-4 |
| Business Practice Address: | 1751 Southcross Dr W Burnsville, MN - 553067012 |
| Business Phone Number: | 9528927690 |
| Business Fax Number: | 9528984930 |
| Mailing Address: | 1751 Southcross Dr W, BURNSVILLE |
| State: | MN |
| Postal Code: | 553067012 |
| Phone Number: | 9528927690 |
| Fax Number: | 9528984930 |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 04/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0809X |
| License Number: | R115681-4 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |