# MS. TAJUANA B BRADLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1215266358
- **Gender:** F
- **Credential:** FNP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | RN148400 | GA | Yes |

## Other

- **Enumeration date:** 12/21/2009
- **Last updated:** 08/25/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 202I502094 | MEDICARE PTAN | GA |
| 05 | — | 215815240E | — | GA |
| 05 | — | 215815240F | — | GA |