Boothe, Bradley David
Boothe, Bradley David is an sole proprietor health care provider with primary practice located at 998 S Dorset Rd , Troy OH 45373-4753. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Boothe, Bradley David can be contacted via phone (937) 440-7358.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APRN.CNP.022278 | Ohio |
Profile Details
| NPI number | 1275032914 |
|---|---|
| LBN Legal business name | Boothe, Bradley David |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 8th, 2018 |
| Last updated | May 16th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275032914 | NPPES |
| Ohio | MEDICAID | 0265013 |
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