Bradley, William
Bradley, William is an sole proprietor health care provider with primary practice located at 200 Southland Dr , Sikeston MO 63801-4403. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Bradley, William can be contacted via phone (573) 427-1770.Contact Information
Primary practice address
200 Southland Dr
Sikeston MO 63801-4403
Phone: (573) 427-1770
Fax: (573) 472-4050
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 131573 | Missouri |
Profile Details
| NPI number | 1649375940 |
|---|---|
| LBN Legal business name | Bradley, William |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 13th, 2006 |
| Last updated | Jun 8th, 2015 - about 11 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 | 1649375940 | NPPES |
| Missouri | MEDICAID | 427752506 |
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