Bradshaw, Alicon Kay

Bradshaw, Alicon Kay is an individual health care provider with primary practice located at 4601 Chamberlain Ln , Louisville KY 40241-1159. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Bradshaw, Alicon Kay can be contacted via phone (502) 384-2844.

Contact Information

Primary practice address
4601 Chamberlain Ln Louisville KY 40241-1159
Phone: (502) 384-2844
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 3006770 Kentucky

Profile Details

NPI number 1164768834
LBN Legal business name Bradshaw, Alicon Kay
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 27th, 2012
Last updated Aug 9th, 2013 - about 13 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 1164768834 NPPES
Kentucky MEDICAID 7100231860

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