| Doctor Name: | MR. NICHOLAS BRADLY |
| NPI Number: | 1649514118 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | N.P. |
| License Number: | 825936 |
| Business Practice Address: | 36000 Darnall Loop Carl R. Darnall Army Medical Center Ft. Hood, TX - 76544 |
| Business Phone Number: | 6185347854 |
| Business Fax Number: | |
| Mailing Address: | 36000 Darnall Loop, Carl R. Darnall Army Medical Center FT. HOOD |
| State: | TX |
| Postal Code: | 76544 |
| Phone Number: | 6185347854 |
| Fax Number: | |
| NPI Enumeration Date: | 11/21/2012 |
| NPI Last Update Date: | 11/21/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 825936 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |