Brady-Bardsher, Shannon Renee

Brady-Bardsher, Shannon Renee is an individual health care provider with primary practice located at 2220 W Iowa Ave , Chickasha OK 73018-2738. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Brady-Bardsher, Shannon Renee can be contacted via phone (405) 779-2834.

Contact Information

Primary practice address
2220 W Iowa Ave Chickasha OK 73018-2738
Phone: (405) 779-2834
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 83612 Oklahoma

Profile Details

NPI number 1316211600
LBN Legal business name Brady-Bardsher, Shannon Renee
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 3rd, 2012
Last updated Oct 9th, 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 1316211600 NPPES
Oklahoma MEDICAID 200452510A

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