Bradley, Katherine Elaine

Bradley, Katherine Elaine is an individual health care provider with primary practice located at 615 Volunteer Parkway , Bristol TN 37620. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bradley, Katherine Elaine can be contacted via phone (423) 989-3223.

Contact Information

Primary practice address
615 Volunteer Parkway Bristol TN 37620
Phone: (423) 989-3223
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0017138087 Virginia

Profile Details

NPI number 1154416329
LBN Legal business name Bradley, Katherine Elaine
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Sep 12th, 2014 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154416329 NPPES
Tennessee MEDICAID 4046961
Tennessee MEDICAID 4401061
Tennessee Other 4100703
Tennessee Other TN0103
Tennessee Other 020684999
Tennessee Other DA3103

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