Doctor Name: | LAUREN LEWIS BRADLEY |
NPI Number: | 1063883551 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | 95003232 |
Business Practice Address: | 1077 W Morton Ave Ste 101 Porterville, CA - 932571989 |
Business Phone Number: | 5597815022 |
Business Fax Number: | 5597816990 |
Mailing Address: | 1077 W Morton Ave Ste 101, PORTERVILLE |
State: | CA |
Postal Code: | 932571989 |
Phone Number: | 5597815022 |
Fax Number: | 5597816990 |
NPI Enumeration Date: | 10/09/2015 |
NPI Last Update Date: | 11/13/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP2300X |
License Number: | 95003232 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |